Coosalud

What Coosalud does

Coosalud (legal name COOSALUD EPS) is a Colombian Entidad Promotora de Salud (EPS) headquartered in Cartagena de Indias that administers mandatory health insurance under both the subsidized (Régimen Subsidiado) and contributory (Régimen Contributivo) regimes of the Colombian SGSSS system. Founded circa 1996 originally as an ARS (Administradora del Régimen Subsidiado), the company has scaled over three decades to serve affiliated members nationwide through a mix of physical service offices, an IPS provider network (hospitals, clinics, laboratories), and a portfolio of digital self-service portals including Punto Fácil, Portal Autogestión, Portal IPS, Portal Empleador, Salus (affiliation and registration), Dynamicoos (CRM for providers), and SIPRA (provider directory). The company also operates branded health programs such as Cuídate Mujer (women's preventive care), Tómate a Pecho la Vida (breast cancer awareness), Cuidarse del VIH es de Valientes (HIV awareness), and Tu Vida Sin Humo (smoking cessation), and holds ISO 9001, ISO 14001, ISO 45001, and IQNet certifications from ICONTEC.

Coosalud's revenue model is built on regulated per-capita capitation payments (UPC) disbursed by ADRES for subsidized members, payroll-based employer/employee contributions for the contributory regime, and regulated copagos/cuotas moderadoras with exemptions for vulnerable populations (Sisbén Level 1, children under 1, victims of armed conflict). Pricing is fully dictated by Ministry of Health schedules rather than negotiated market rates, which makes the business a regulated utility rather than a commercial insurer. Distribution is multi-channel: physical offices, government Sisbén enrollment points, IPS provider referrals, and digital self-service — a hybrid GTM appropriate for a payer that serves both employed contributors and government-subsidized beneficiaries.

As of 2024–2026, Coosalud operates under formal administrative intervention by the Colombian Ministry of Health and Supersalud, following a forensic audit by the Comptroller General's Office that identified alleged irregularities including ~$221,000 million COP in EPS resources used to guarantee private credit for a related entity, ~$25,000 million COP in unjustified payments to linked companies, more than 72,000 pending medicine deliveries, and the appointment of eight legal representatives in under two years. The Attorney General's Office has opened a disciplinary investigation into President Jaime Miguel González Montaño and seven board members, and the Petro administration has publicly alleged that approximately 5 trillion pesos in public funds may have been diverted to offshore accounts. Hospital Universitario del Valle has publicly accused Coosalud representatives of demanding bribes for payment authorization, prompting temporary service suspension to Coosalud affiliates.

Name

Coosalud

Legal name

COOSALUD EPS

Website

https://coosalud.com

Company type

Private

Founded year

1996

Operating status

Operating

Headcount range

101–250 employees

Short description

Coosalud is a Colombian Entidad Promotora de Salud (EPS) administering health insurance under both subsidized and contributory regimes, serving affiliated members nationwide through IPS providers, digital portals, and physical offices.

Ownership category

akta.pro rank

Product category

Health Insurance (EPS)

NAICS

Direct Health and Medical Insurance Carriers (524114), Direct Life, Health, and Medical Insurance Carriers (52411)

SIC

Hospital & Medical Service Plans (6324), Services-Health Services (8000)

akta.pro primary industry

Care Management & Population Health Program Administration (HLAEALAG)

akta.pro secondary industries

Utilization Management (Prior Auth/Medical Necessity) Administration (HLAEALAF), Individual Health Insurance Administration (TPA/ASO) (FSAIAEAK), Association & PEO Group Health Plans (AHP/PEO-Sponsored) (FSAIAFAH), Healthcare-Linked Social Benefits Administration (e.g., Medicaid/Means-Tested Health Coverage) (BPAIAKAH)

Keywords

• Health insurance administration
• Managed care services
• Health plan provider
• Subsidized health regime
• Contributory health regime

Headquarters

HQ city

Cartagena

HQ country

Colombia

HQ region

Latin America

Offices2 records

Markets served

GTM type

B2C

Offering type

Services

Cost components

Operations, Personnel, Supply Chain, Technology or R&D, Marketing or Sales, Infrastructure

Revenue model

1. Per-capita capitation payments (UPC): Government per-capita payments from ADRES for subsidized regime members. The UPC (Unidad de Pago por Capitación) is the primary funding mechanism from the Colombian government for each affiliated member in the subsidized regime.
2. Contributory regime contributions: Monthly contributions from employees and employers in the contributory regime based on income levels, managed through payroll deductions.
3. Copagos and Cuotas Moderadoras: Moderate fees and co-payments collected from members for certain services, with exemptions for vulnerable populations including Sisbén Level 1, children under 1 year, and victims of armed conflict.

Pricing tiers

Go-to-market motion1 record

Distribution channels4 records

Marketing channels6 records

Core offering

Coosalud operates as an Entidad Promotora de Salud (EPS) administering health insurance coverage under Colombia's subsidized (R\u00e9gimen Subsidiado) and contributory (R\u00e9gimen Contributivo) regimes. It contracts with affiliated IPS healthcare providers to deliver covered medical services to affiliated members and supplements this with digital self-service portals and preventive health programs.

Product overview

Coosalud EPS is a Colombian health insurer (Entidad Promotora de Salud) operating under both the Contributive and Subsidized regimes, providing comprehensive health insurance administration to affiliated members across Colombia. The company's product portfolio centers on its core EPS platform, supported by multiple digital portals including Punto Fácil (self-service portal), Portal Autogestión (member management), Portal IPS (provider services), Portal Empleador (employer services), Salus (affiliation system), and Dynamicoos CRM. The company also offers specialized health programs including Cuídate Mujer for women's health, Tómate a Pecho la Vida for breast cancer prevention, Cuidarse del VIH es de Valientes for HIV awareness, and Tu Vida Sin Humo for smoking cessation. Additional services include ethical reporting (Línea Ética), wait time reporting (Tiempos de Espera), and the SIPRA provider directory. All services are accessible through the company's national office in Cartagena, Bolívar, Colombia.

Differentiator

Problem solved

Functional benefit

Brands

• Cuídate Mujer: Women's health program focusing on prevention, mammograms, and cancer screening
• Coosalud En Pos de tu Bienestar
• Cuidarse del VIH es de valientes
• Tómate a pecho la vida

Products and services

• Coosalud EPS (R\u00e9gimen Subsidiado y Contributivo) Core health insurance administration product for individuals and families in Colombia, providing coverage under both the subsidized (government-funded) and contributory (employer/employee-funded) regimes, with access to affiliated hospitals, clinics, laboratories, and preventive care programs.
• Punto F\u00e1cil

Quantifiable outcome

• 95%+ vaccination coverage target for children and vulnerable populations in national vaccination campaigns
• +1 more outcomes

Named customers1 record

Segments5 records

Ideal customer profiles3 records

Technology focussed No

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Feature5 records

Partnerships

Six partnerships are on record, tiered core.

• Supersalud (Superintendencia Nacional de Salud)coreOthersGovernment regulatory oversight body that regulates and supervises health insurers in Colombia. Supersalud conducted intervention of Coosalud EPS in 2024 amid financial and administrative irregularities identified through forensic audits.
• ADRES (Administradora de los Recursos del Sistema General de Seguridad Social en Salud)coreOthersGovernment agency responsible for managing and disbursing health system resources. ADRES processes per-capita payments (UPC) to EPS entities like Coosalud for affiliated members in the subsidized regime.
• IPS Network (Instituciones Prestadoras de Servicios de Salud)coreChannel Partner/ Reseller/ DistributorNetwork of affiliated hospitals, clinics, laboratories, and healthcare providers that deliver healthcare services to Coosalud members. Includes institutions like Hospital Universitario del Valle.
• Ministry of Health and Social Protection (MinSalud)coreOthersGovernment ministry responsible for national health policy. Coordinates national vaccination campaigns, health programs, and regulatory framework that Coosalud participates in as an EPS.
• Contraloría General de la RepúblicacoreOthersGovernment auditing body that conducted forensic audit of Coosalud identifying alleged irregularities including $221,000 million in resources used for private credit guarantees, unjustified payments exceeding $25,000 million to linked companies, and administrative instability.
• Procuraduría General de la NacióncoreOthersColombian Attorney General's Office that opened disciplinary investigation into Coosalud President Jaime Miguel González Montaño and seven board members for alleged financial irregularities involving unexplained payments to third parties, concentration in healthcare fund dispersion, and a coworking contract.

Scale indicators3 records

Recent moves7 records

Expansion highlights4 records

Direct peers

• EPS Sura: One of Colombia's leading private EPS entities operating contributory and subsidized regimes with a strong preventive-care and chronic-disease-management focus; directly comparable in product scope and target member base.
• Coomeva EPS: Historically significant Colombian EPS serving contributory and subsidized populations through cooperative networks; comparable in dual-regime structure and provider-affiliation model.
• Emssanar: Colombian EPS serving southwestern Colombia under both regimes, also under Supersalud intervention in2024; directly comparable in product offering and current regulatory distress.
• Nueva EPS: Colombia's largest public EPS administering both subsidized and contributory regimes; also currently under government intervention, making it the closest direct comparator in scale, regime mix, and regulatory status.
• Famisanar: Bogotá-region Colombian EPS serving contributory and subsidized populations through Cafam and Colsubsidio; comparable in dual-regime structure and IPS-network distribution model.
• Asmet Salud: Colombian EPS focused primarily on the subsidized regime, also under government intervention; comparable as a regime-mixed peer facing similar forensic-audit-driven regulatory action.
• Mutual Ser: Colombian EPS operating primarily in the subsidized regime with national reach; comparable in member-services and population-health management focus, particularly in lower-income segments.
• Compensar EPS: Colombian compensation-family EPS administering both regimes with integrated provider network; comparable in product offering, member self-service portal approach, and preventive-care focus.
• Salud Total EPS: Colombian EPS with national presence operating both regimes; closely comparable in offering, preventive-care programs, and B2B/B2C employer relations.
• Sanitas EPS: Major Colombian EPS administered by Keralty/Compañía de Medicina Prepagada covering contributory and subsidized populations; directly comparable in dual-regime operations and provider-network model.

Market position

Strengths4 records

Weaknesses4 records

Competitive moat4 records

Key risks6 records

Key highlights6 records

Customer concentration

• Xx.com/Coosalud_
• YouTubeyoutube.com/user/Coosaludepss
• Facebookfacebook.com/CoosaludEPS
• Instagraminstagram.com/coosaludeps
• LinkedInlinkedin.com/company/coosalud

Revenue estimate

Valuation estimate

Number of profiles

Profiles3 records

Funding overview

Funding rounds

Investors

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A

Investments

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about Coosalud