SSI Saúde

What SSI Saúde does

SSI Saúde (legal name Caixa de Assistência Sistema Saúde Integral) is a self-managed (autogestão) private health plan operator founded in 1995 in Caxias do Sul, Brazil by Sr. Raul Randon. The company exclusively serves employees, retirees, and dependents of sponsoring employers — principally RandonCorp and affiliated industrial companies (Frasle Mobility, Triches, Tricorte, RASIP) — covering more than 23,000 beneficiaries across the Serra Gaúcha region (Caxias do Sul, Farroupilha, Flores da Cunha, Antônio Prado, São Marcos). The plan is regulated by ANS and classified as 'Ambulatorial Hospitalar com Obstetrícia,' with LGPD-compliant data governance and TISS-standard information exchange.

The product portfolio centers on a single health plan, a proprietary mobile application (available on iOS and Android) that consolidates the digital insurance card, the Token Digital electronic-signature feature, telemedicine access, reimbursement, and provider search, plus an integrated preventive medicine stack: Primary Health Care (APS) with family-centered care teams, the Telemedicina TopMed service with AI-assisted clinical triage via the Medy virtual assistant (95% claimed resolution), and the recently launched Voz Presente Beneficiary Committee. Operational layers include the Autorizador Web for provider authorizations, an electronic medical guide system, and a credentialed network of over 600 healthcare professionals. In July 2024, SSI Saúde formalized a strategic collaboration with Hospital Israelita Albert Einstein, committing R$ 1.5 million in first-phase investment for AI-driven health profiling across the membership.

The business model is B2B2C subscription-based: sponsoring companies fund the plan through monthly premiums on behalf of their employees and retirees, while beneficiaries pay transaction-based coparticipation fees on consultations (R$ 45.00 as of October 2024) and certain exams/therapies. Telemedicine is offered free of coparticipation. Distribution occurs entirely through corporate HR relationships — the plan is not commercially sold to the public. Recent capital allocation has prioritized digital experience, AI-enabled care pathways, and organizational culture (first Culture Survey in 2026), rather than expansion of the closed membership base.

Name

SSI Saúde

Legal name

Caixa de Assistência Sistema Saúde Integral

Website

https://ssisaude.com.br

Company type

Private

Founded year

1995

Operating status

Operating

Short description

SSI Saúde is a self-managed (autogestão) private health plan operator founded in 1995, exclusively serving 23,000+ employees, retirees, and dependents of sponsoring companies (RandonCorp group, Triches, Tricorte) across Brazil's Serra Gaúcha region under ANS regulation.

Ownership category

akta.pro rank

Product category

Health Insurance

NAICS

Health Care and Social Assistance (62)

SIC

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

akta.pro primary industry

MA Chronic Condition Management & Supplemental Benefits (SSBCI) (HLAEACAI)

Keywords

• Health insurance plan
• Self-managed healthcare
• Corporate health benefits
• Preventive medicine programs
• Telemedicine services

Headquarters

HQ city

Caxias Do Sul

HQ country

Brazil

HQ region

Latin America

Offices1 record

Markets served

GTM type

B2C

Offering type

Services

Cost components

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

Revenue model

1. Health Insurance Premiums: SSI Saúde generates revenue through monthly premium payments collected from sponsoring companies on behalf of their employees (active and inactive/retirees). The plan operates under a self-management model (autogestão) as a supplementary health operator regulated by ANS.

Pricing tiers

Go-to-market motion1 record

Distribution channels3 records

Marketing channels6 records

Core offering

SSI Saúde is a self-managed (autogestão) private health insurance operator that provides comprehensive healthcare coverage exclusively to employees of sponsoring companies (RandonCorp, Triches, Tricorte) and their families in the Serra Gaúcha region of Brazil. The plan covers consultations, exams, therapies, hospitalizations, and preventive medicine programs for over 23,000 beneficiaries. Services are delivered through a network of 600+ credentialed healthcare providers, a mobile app with digital card and telemedicine functionality powered by TopMed, and AI-assisted clinical triage via the Medy virtual assistant.

Product overview

SSI Saúde is a self-managed private health insurance operator offering a unified health plan exclusively for employees of sponsoring companies (RandonCorp group, Triches, Tricorte). The portfolio consists of the core SSI Saúde health insurance plan complemented by a mobile application serving as the primary beneficiary interface. The app consolidates access to the digital insurance card (Cartão Virtual) with the Token Digital for electronic attendance confirmation, telemedicine via TopMed, reimbursement requests, and provider network search. The plan includes integrated Preventive Medicine programs (Medicina Preventiva) with the Primary Health Care (APS) module providing family-centered digital care teams at no copayment. A Beneficiary Committee (Voz Presente) enables member participation in service improvement. The provider-facing side includes the Autorizador Web for authorization and an electronic guide (Guia Eletrônica) system. A virtual library provides health education content. A collaboration with Hospital Israelita Albert Einstein brings AI-powered health profiling for personalized preventive programs.

Differentiator

Problem solved

Functional benefit

Products and services

• Plano de Saúde SSI Saúde (SSI Saúde Health Plan)
• Aplicativo SSI Saúde (Mobile App)
• Telemedicina SSI Saúde via TopMed
• Atenção Primária à Saúde (APS)
• Medicina Preventiva (Preventive Medicine Programs)

Quantifiable outcome

• Telemedicine resolution rate of 95% of cases
• +3 more outcomes

Named customers3 records

Segments3 records

Ideal customer profiles1 record

Technology focussed No

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Integration1 record

AI capability5 records

Feature3 records

Partnerships

Three partnerships are on record, tiered core.

• Hospital Israelita Albert EinsteincoreStrategic or Co-development Partner · 1 July 2024Collaboration with Hospital Israelita Albert Einstein to enhance health services and beneficiary experience in the Serra Gaúcha region. Initial investment of R$ 1.5 million for health profiling research, where AI analyzes beneficiary health habits to develop personalized preventive care programs. Einstein was ranked 28th best hospital in the world and best in the Southern Hemisphere and Latin America by Newsweek in 2024.
• TopMedcoreTechnology or IntegrationTechnology partnership for telemedicine platform. Starting July 2024, SSI Saúde's telemedicine operates through TopMed platform, introducing AI-powered clinical triage via Medy virtual assistant for 24/7 medical assistance without wait times.
• RandonCorp CompaniescoreOthersRandonCorp and affiliated companies (Frasle Mobility, Triches, Tricorte, RASIP) are sponsoring companies whose employees receive SSI Saúde health benefits. These companies fund and support the health plan as an employee benefit.

Scale indicators4 records

Recent moves6 records

Expansion highlights5 records

Direct peers

• Unimed (national cooperative system): Unimed is Brazil's largest cooperative health plan network, providing ANS-regulated private health coverage across all states. While commercially marketed rather than captive, its regional medical cooperative structure and primary care orientation make it a strong comparable for self-managed models like SSI Saúde.
• Petrobras AMS (Assistência Multidisciplinar de Saúde): Petrobras AMS is the in-house, employer-sponsored health benefit for Petrobras employees and retirees under the autogestão model. It shares SSI Saúde's captive membership structure, ANS-regulated operator status, and emphasis on integrated primary and preventive care.
• Cassi (Caixa de Assistência dos Funcionários do Banco do Brasil): Cassi is one of Brazil's largest autogestão health plan operators, exclusively serving employees of Banco do Brasil and affiliates. It is the closest functional peer to SSI Saúde given the identical self-managed, employer-sponsored model, ANS regulation, and focus on preventive primary care for a captive membership.
• Geap (Fundação Geap Saúde): Geap operates as a self-managed (autogestão) health plan for public-sector and corporate employees under ANS regulation. Its structure — sponsoring-employer funded, no commercial sales, focus on primary care — closely mirrors SSI Saúde's operating model.
• Eletros-Saúde: Eletros-Saúde is a Brazilian autogestão health plan originally serving employees of the Eletrobras group, operating exclusively for sponsoring companies and their beneficiaries. The closed, employer-funded model and preventive care orientation are directly comparable to SSI Saúde.

Broad incumbents

• SulAmérica Saúde: SulAmérica is a major Brazilian commercial health insurer with a broad provider network and corporate group plans. It competes with SSI Saúde for the same corporate health benefit budget at sponsoring employers like RandonCorp, Triches and Tricorte.
• Amil: Amil is a large national commercial health plan operator with extensive provider networks and corporate plans. It overlaps with SSI Saúde in employer-sponsored health benefits and ANS-regulated operations but operates at much larger national scale and sells commercially.
• Hapvida NotreDame Intermédica: Hapvida is one of Brazil's largest vertically integrated health plan and hospital operators with a strong presence in northern and northeastern regions. Comparable to SSI Saúde in operating integrated health plans under ANS regulation, though with much broader geographic footprint and commercial distribution.
• Bradesco Saúde: Bradesco Saúde is a leading commercial health plan operator in Brazil offering corporate and individual plans. It is a relevant comparable for SSI Saúde in the corporate health benefit segment where employers choose between captive autogestão and large commercial incumbents.

Others

• Hospital Israelita Albert Einstein: Hospital Israelita Albert Einstein is SSI Saúde's strategic AI/preventive care partner and operates its own health plan (Einstein Saúde) as well as a global-rated hospital network. Included as an ecosystem/partner relationship rather than direct competitor, but strategic to SSI's data-driven preventive care roadmap.

Market position

Strengths4 records

Weaknesses5 records

Competitive moat5 records

Key risks6 records

Key highlights6 records

Customer concentration

• Facebookfacebook.com/ssisaude
• LinkedInlinkedin.com/company/ssisaude-caixadeassistencia
• Instagraminstagram.com/ssisaude

Compliance3 records

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 SSI Saúde