MUTUAL SER EPS

What MUTUAL SER EPS does

Mutualser EPS is a private Colombian Entidad Promotora de Salud (EPS) that administers both the subsidized and contributive health regimes under the country's mandatory social security system, serving approximately 2.5 million individual affiliates across the Caribbean departments of Atlántico, Bolívar, Córdoba, Magdalena, Sucre, and Cesar. The company operates as a regulated health insurer, deriving revenue from per-capita UPC (Unidad de Pago por Capitación) payments — government-funded for the subsidized regime and payroll-contribution-funded for the contributive regime — supplemented by solidarity contributions from Sisbén Group D populations. Customer acquisition runs through physical offices, the SAT national affiliation platform, the #603 free short code, call centers, and the afiliados.mutualser.com portal.

The product portfolio centers on a digital service ecosystem anchored by ZonaSer Afiliado (a virtual member portal with a free-navigation mobile application, recognized in 2021 as the best solution to democratize technology) and ZonaSer Prestador (a provider-facing portal). Physical service delivery is handled through four exclusive IPS offices in Cartagena, Barranquilla, Soledad, and Montería, supplemented by 494 integrated network providers and Mobile Rosa mobile units that deliver mammographies and cytologies to remote municipalities. The company runs 18–20 health risk management programs — including Mujer Sana (cancer prevention), De Todo Corazón (hypertension/diabetes), Ser Madre e Hijo (maternal care), and Ser Joven (adolescent health) — and in 2022 implemented the iBreastExam electronic palpation technology as the first EPS on the Colombian Caribbean coast.

Operationally, Mutualser is governed by a Junta Directiva led by President Amaury Guzmán, with Galo Viana as Gerente General; the broader team includes a Commercial Director, Scientific Director, Regional Managers for Sucre, Magdalena, and Bolívar, and a Health Risk Management Manager. The organization holds full ISO 9001:2015 certification across all five regional operations (granted by ICONTEC), supervigilado status with Supersalud, a 904/1000 Global Reputation Index score from Centro Nacional de Consultoría (300 points above sector average), and five consecutive years of recognition as the best EPS in the subsidized regime for high-cost disease management by Cuenta de Alto Costo. Strategic partnerships span Gobernación de Sucre (COVID-19 vaccination), Universidad de los Andes (research via Consultandes), Fundación SerSocial IPS, and Clínica Blas de Lezo.

Name

MUTUAL SER EPS

Legal name

Mutualser EPS

Website

https://mutualser.org

Company type

Private

Operating status

Operating

Headcount range

101–250 employees

Short description

Mutualser EPS is a private Colombian health insurance company (EPS) administering subsidized and contributive regimes for approximately 2.5 million affiliates across the Caribbean departments of Atlántico, Bolívar, Córdoba, Magdalena, Sucre, and Cesar, using a digital service ecosystem (ZonaSer platform, mobile app, #603 hotline) and Mobile Rosa units for preventive care delivery.

Ownership category

akta.pro rank

Product category

Health Insurance

NAICS

Direct Health and Medical Insurance Carriers (524114)

SIC

Hospital & Medical Service Plans (6324)

akta.pro primary industry

Individual Health Insurance Brokerage & Distribution (FSAIAEAL)

Keywords

• Colombian health insurance
• Subsidized health coverage
• Contributory health coverage
• Digital health services
• Preventive care programs

Headquarters

HQ city

Cartagena

HQ country

Colombia

HQ region

Latin America

Offices5 records

Markets served

GTM type

B2C

Offering type

Services

Cost components

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

Revenue model

1. Subsidized Regime (Régimen Subsidiado): Government-funded health insurance for poor and vulnerable populations. Revenue comes from per-capita payments from the Colombian health system (POS contributions) for enrolled members.
2. Contributive Regime (Régimen Contributivo): Health insurance funded through payroll contributions from formally employed workers, independent workers, and pensioners. EPS receives capitation payments (UPC) from affiliates and government subsidies.
3. Solidarity Contribution (Contribución Solidaria): For populations classified in Sisbén Group D who don't qualify for subsidized or contributive regimes. Monthly contributions based on classification.

Go-to-market motion1 record

Distribution channels5 records

Marketing channels8 records

Core offering

Mutualser EPS administers subsidized and contributory health insurance and arranges medical care for approximately 2.5 million users in Colombia's Caribbean region. It serves members through a 494-provider network, exclusive IPS offices, digital self-service channels, mobile outreach, health risk management programs, telemedicine, electronic authorizations, and preventive screening services.

Product overview

Mutualser EPS operates as a Colombian health insurance company (EPS) administering both contributory and subsidized health regimes for approximately 2.5 million users in the Caribbean region. The product portfolio centers on a digital service ecosystem comprising ZonaSer Afiliado (virtual member portal with mobile app), ZonaSer Prestador (provider portal), PQRD complaints system, and the #603 hotline. Physical service delivery is supported by exclusive IPS locations, Mobile Rosa units for cancer screening, and the iBreastExam electronic palpation technology. Health risk management includes 18+ programs such as Mujer Sana (cancer prevention), De Todo Corazón (chronic disease), Ser Madre e Hijo (maternal care), and Ser Joven (youth health). The Family Health Model provides community-based care through household characterization and multidisciplinary teams.

Differentiator

Problem solved

Functional benefit

Brands

• ZonaSer Afiliado: Virtual office portal for affiliates to manage health services and medications
• ZonaSer Prestador
• Mujer Sana
• Marea Rosa
• CreSER Juntos
• Ser + Unidos
• Ser Joven
• De Todo Corazón
• Ser Madre e Hijo

Products and services

• Subsidized Regime (Régimen Subsidiado) Government-funded health coverage for poor and vulnerable populations, with per-capita payments made to the EPS for enrolled members.
• Contributory Regime (Régimen Contributivo) Health coverage for formally employed workers, pensioners, independent workers, and beneficiary families, funded through payroll contributions and capitation payments.
• Solidarity Contribution (Contribución Solidaria) Health coverage for people classified in Sisbén Group D who do not qualify for subsidized or contributive regimes, supported by monthly contributions based on classification.
• ZonaSer Afiliado Virtual self-service portal and mobile application through which affiliates can manage health services, medications, appointments, and administrative tasks without visiting a physical office.
• iBreastExam Technology for Breast Cancer Detection Electronic intelligent palpation service using a device with 648 sensors and a Bluetooth-connected mobile application to support early breast cancer detection.

Quantifiable outcome

• 92% user satisfaction rate
• +6 more outcomes

Named customers1 record

Segments3 records

Ideal customer profiles3 records

Technology focussed No

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Integration5 records

Feature4 records

Partnerships

Five partnerships are on record, tiered core and minor.

• Gobernación de SucrecoreStrategic or Co-development Partner · 17 August 2022Regional government partnership for COVID-19 vaccination campaign. Mutualser received recognition for achieving excellent vaccination coverage through apadrinamiento of 9 municipalities, mobile vaccination units, and house-to-house campaigns. Ivette Sossa, Regional Manager, received personal distinction as best manager.
• Universidad de los AndescoreStrategic or Co-development PartnerInnovative alliance through Consultandes program for research and knowledge management. Actions include academic collaborations, research projects, and evidence-based healthcare improvements.
• Fundación SerSocial IPScoreStrategic or Co-development PartnerOperational partner for health services including cancer care, family health model implementation, and vaccination campaigns. Led initiatives like karate therapy for children with cancer and the Family and Community Health Attention Model in El Carmen de Bolívar, San Juan, and San Jacinto.
• Clínica Blas de LezocoreImplementation/ SI/ Consulting PartnerHealthcare provider where pediatric oncology services are delivered. 76 children (36 from Cartagena, 40 from rest of Bolívar) receive treatment including karate therapy sessions.
• Federación Nacional de Sordos de ColombiaminorStrategic or Co-development PartnerPartnership to train customer service personnel in accessibility for deaf users, strengthening attention to people with hearing disabilities.

Scale indicators14 records

Recent moves10 records

Expansion highlights5 records

Direct peers

• EPS Sura: Colombian EPS affiliated with Grupo Sura, offering contributive and subsidized health insurance. Direct competitor with similar member base and service model across multiple Colombian regions.
• Coomeva EPS: Colombian cooperative-based EPS offering contributive regime health insurance. Historically a major direct competitor in the same UPC-driven capitation model, though has undergone recent restructuring.
• Nueva EPS: One of the largest EPS in Colombia administering both contributory and subsidized regimes. Directly comparable as a health insurer operating under the same UPC capitation model and serving similar low-income and formal-worker populations.
• Salud Total EPS: Colombian EPS providing health insurance services under the mandatory health system. Operates with similar UPC capitation model and serves both subsidized and contributive populations nationwide.
• Sanitas EPS: Major Colombian EPS providing health insurance under both contributive and subsidized regimes. Comparable in product offering (mandatory health plan administration), business model (capitation payments), and target customer base.
• Famisanar EPS: Colombian EPS administered through a partnership between Cafam and Colsubsidio, offering health insurance under both regimes. Comparable business model and customer segments as Mutualser.
• Medimás EPS: Colombian EPS operating in multiple regions under contributive and subsidized regimes. Direct competitor with similar capitation model and member demographic, particularly relevant after recent Colombian EPS industry consolidation.
• Aliansalud EPS: Colombian EPS providing prepaid and contributory health plans. Comparable as a health insurer operating under the Colombian regulatory framework with similar member service offerings.

Broad incumbents

• Compensar EPS: Colombian compensation fund administering health services including EPS operations as part of broader social benefits portfolio. Comparable in health insurance offering but larger scale and more diversified services than Mutualser.
• Sura Prepagada: Colombian prepaid health plan provider under Grupo Sura. Adjacent in health plan administration but focused on voluntary prepaid plans rather than mandatory regimes, serving higher-income segments.

Market position

Strengths5 records

Weaknesses4 records

Competitive moat6 records

Key risks5 records

Key highlights7 records

Customer concentration

• Xtwitter.com/mutualser_
• YouTubeyoutube.com/@mutualser
• Facebookfacebook.com/mutualser
• LinkedInlinkedin.com/company/mutual-ser-eps
• Instagraminstagram.com/mutualser

Compliance2 records

Revenue estimate

Valuation estimate

Number of profiles

Profiles8 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 MUTUAL SER EPS