Grupo Caberj

What Grupo Caberj does

Grupo Caberj is a privately held Brazilian health plan operator (operadora de planos privados de assistência à saúde) founded in 1972 and headquartered in Centro, Rio de Janeiro. The company provides supplementary health insurance coverage to corporate clients, individuals, families, and pregnant women in Rio de Janeiro state, operating under the brands Caberj and Integral Saúde. Its plan portfolio spans four main lines: Colaborador (corporate, including Basico 20 and Pleno 20 tiers), Afinidad (individual and family coverage across Basico, Especial, Executivo, and Pleno tiers), Mater (maternal coverage), and Maximus (premium Adesão and Plus tiers). Revenue is generated through recurring health insurance premiums collected from beneficiaries.

The company's technical infrastructure centers on the Portal TISS Caberj, an ANS-mandated standardized health information exchange (Troca de Informações na Saúde Suplementar) system that hosts over a dozen standardized forms and guides for electronic data interchange between the operator and its accredited healthcare providers. These include consultation guides, professional service and diagnostic forms, hospitalization request and summary guides, chemotherapy and radiotherapy request annexes, orthoses/prostheses authorization forms, claim dispute (glosa) procedures, and TUSS equivalence tables. The TISS standard is a regulatory requirement enforced by ANS to standardize administrative actions and reduce information asymmetry in the supplementary health market.

Services are delivered through a regional network of accredited hospitals and clinics in Rio de Janeiro, including Hospital Copacabana, Santa Teresa, Hospital Alameda, and Hospital da Criança, supplemented by clinics, laboratories, and diagnostic providers. The company distributes plans via direct sales channels (Credenciamento sector), with the operator processing claims, authorizations, and provider billing internally. Grupo Caberj employs 101-250 staff and operates without disclosed institutional investment, parent company, or external funding, indicating an independently financed regional operator with 50+ years of operating history.

Name

Grupo Caberj

Legal name

Grupo Caberj

Website

https://caberj.com.br

Company type

Private

Founded year

1972

Operating status

Operating

Headcount range

101–250 employees

Short description

Grupo Caberj is a privately held Rio de Janeiro-based Brazilian health plan operator providing multi-tier supplementary health insurance (corporate, individual, maternal, premium) through an ANS-regulated network of accredited hospitals and clinics in Rio de Janeiro state.

Ownership category

akta.pro rank

Product category

Private Health Insurance

NAICS

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

SIC

Hospital & Medical Service Plans (6324), Accident & Health Insurance (6321)

akta.pro primary industry

Group HMO Plans (FSAIAFAK)

akta.pro secondary industry

Provider Network, Credentialing & Contracting Support (BPAAAFAI)

Keywords

• Private health plans
• Suplementary health insurance
• Corporate health benefits
• Maternal health coverage
• Health plan provider network

Headquarters

HQ city

Rio De Janeiro

HQ country

Brazil

HQ region

Latin America

Offices1 record

Markets served

GTM type

B2B and B2C

Offering type

Services

Cost components

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

Revenue model

1. Health Insurance Premiums: Grupo Caberj operates as a health plan operator (operadora de planos privados de assistência à saúde) collecting premiums from beneficiaries in exchange for healthcare coverage. The company manages multiple health plan tiers including basic, special, executive, maternal, and maximus variants.

Distribution channels2 records

Marketing channels1 record

Core offering

Grupo Caberj is a private health plan operator (operadora de planos privados de assistência à saúde) regulated by ANS, selling tiered health insurance plans to corporate clients and individual/family subscribers in Rio de Janeiro. Coverage spans hospitalizations, consultations, diagnostic procedures (laboratory tests, imaging), chemotherapy, radiotherapy, psychiatric care, obstetric services, and dental coverage. The company provides an ANS TISS-compliant information exchange portal and manages an accredited network of hospitals and clinics in Rio de Janeiro.

Product overview

Grupo Caberj operates as a private health plan operator (operadora de planos privados de assistência à saúde) in Brazil, providing a comprehensive TISS (Troca de Informações na Saúde Suplementar) portal for standardized healthcare data exchange. The core offering consists of the Portal TISS Caberj, which hosts over a dozen standardized forms and guides mandated by ANS (Agência Nacional de Saúde Suplementar) for electronic data interchange between health operators and service providers. These include consultation guides, professional service/diagnostic forms, hospitalization requests and summaries, fee guides, chemotherapy/radiotherapy request annexes, OPME requests, and claim dispute (glosa recurso) forms, along with payment demonstratives. The product portfolio follows the ANS TISS 3.0 standard architecture for healthcare information exchange, with all forms available as downloadable PDFs for healthcare providers.

Differentiator

Problem solved

Functional benefit

Products and services

• Colaborador Health Plans (Corporate Line) Corporate health insurance plans including COLABORADOR BASICO 20 and COLABORADOR PLENO 20, providing employer-sponsored group coverage for employees, including hospitalization, consultations, diagnostic procedures, and treatments in Rio de Janeiro.
• Afinidad Health Plans (Individual/Family Line) Individual and family health insurance plans in the Afinidad line, including Basico, Especial, Executivo, and Pleno tiers for personal and family coverage access to private healthcare providers in Rio de Janeiro.
• Mater Health Plans (Maternal Line) Maternal health insurance plans including Mater Basico, Mater Especial, Mater Executivo, and Mater Pleno, providing prenatal, childbirth, and reproductive health coverage for pregnant women and families.
• Maximus Health Plans (Premium Line) Premium comprehensive health insurance plans including Maximus Adesão and Maximus Plus variants, offering extensive coverage and access to a wider provider network for high-tier subscribers.
• Portal TISS Caberj Web portal providing standardized TISS-compliant electronic data interchange resources between the health plan operator and accredited healthcare providers, offering downloadable guides/manuals, FAQ, and TUSS equivalence reference table access.

Segments4 records

Ideal customer profiles2 records

Technology focussed No

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Scale indicators1 record

Recent moves5 records

Expansion highlights4 records

Direct peers

• Amil: One of Brazil's largest private health plan operators, offering group, individual, and family plans through accredited provider networks. Directly comparable to Grupo Caberj as a similarly regulated ANS operadora competing for corporate and individual subscribers.
• Hapvida NotreDame Intermédica: Vertically integrated Brazilian health plan operator and provider with broad plan tiers. Comparable to Grupo Caberj in operating as an ANS-regulated health plan with corporate and individual plan offerings, though at much larger national scale.
• Porto Seguro Saúde: Brazilian health insurance carrier bundled with the Porto Seguro insurance group, selling group and individual plans. Comparable to Grupo Caberj in offering ANS-regulated corporate and family health plans in southeast Brazil.
• Unimed: Brazil's largest cooperative health plan system, with regional Unimed units operating provider networks and plan products. Comparable to Grupo Caberj in offering multi-tier plans through an accredited regional hospital/physician network.
• Assim Saúde: Regional health plan operator in Rio de Janeiro offering corporate and individual plans. Comparable to Grupo Caberj in geographic concentration in Rio de Janeiro and similar mid-tier ANS-regulated plan offerings.
• Bradesco Saúde: Group health insurance carrier in Brazil, focused on employer-sponsored plans. Directly comparable to Grupo Caberj's COLABORADOR BASICO/PLENO corporate health plan offering, serving similar corporate buyer segments.
• Golden Cross: Brazilian health plan operator offering individual, family, and corporate plans, with a strong historical presence in Rio de Janeiro. Directly comparable to Grupo Caberj as a long-established RJ-focused ANS-regulated operadora serving similar segments.
• SulAmérica Saúde: Major Brazilian health insurance carrier offering group, individual, and family plans. Comparable to Grupo Caberj as a multi-tier ANS-regulated operadora with both corporate and affinity (Afinidad-style) distribution channels.

Market position

Strengths4 records

Weaknesses4 records

Competitive moat4 records

Key risks4 records

Key highlights5 records

Customer concentration

• LinkedInlinkedin.com/company/caberj

Revenue estimate

Valuation estimate

Number of profiles

Profiles1 record

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 Grupo Caberj