Breaking News: SURA Seeks to Leave Colombia’s EPS Health System

Colombia’s largest insurance provider, a business unit of Grupo Sura filed this morning with Colombia’s health superintendency, to withdraw from participating in the country’s EPS (Health Promoting Entity) healthcare system. Under Colombia’s EPS system, which the current president Gustavo Petro seeks to dismantle and replace with a government system, employers contribute a percentage of an employee’s salary to an EPS provider of the employee’s choice. Independent workers pay into the EPS system themselves, and the government has a subsidy plan for low-income and unemployed individuals.

Seguros Sura sent out a statement to its EPS policy holders stating the following:

“The Colombian health system faces major challenges that have been going on for some time and have been aggravated by budget insufficiency in recent years. We have done everything we can to protect the lives and well-being of our members, including by evaluating different alternatives in the current legal framework and in the Government’s new proposals. However, at this time we must take steps to prevent further deterioration, which would prevent us from meeting our obligations.”

According to Sura, the current EPS system is not sustainable and does not provide enough funding for the services committed.  Sura operates a large private health care network, (similar to a HMO or Health Maintenance Organization in the US) with many private clinics and over seven thousand health professionals. Sura’s plan is to “go private” and deal with policyholders and patients directly, not participating in the EPS program anymore. In other words, individuals can purchase Sura private health care policies and pay directly in Sura clinics, but Sura seeks to withdraw from the EPS regimen, which pays a set price determined by the government to health care intermediaties.

Sura was quick to send out an email to private policy holders reminding them that what they have is not EPS Sura.

“Regarding your Health Policy, it is important to remember that you have contracted it with a company independent of EPS SURA. You will continue to have all the current coverage and benefits, such as direct access to the network of more than 7 thousand specialists and health institutions, exclusive care locations, home services, diagnostic aids, wellness program – Vive Más, among others.”

As Sura is a profitable company not facing liquidation or intervention, and is voluntarily seeking to retire from the EPS regimen, there will be no immediate change in service delivery, all clinics, appointments, and policy functions will continue as normal. Sura must now wait on a response from the Colombian government. Holders of Sura’s private healthcare plans such as their Classic and Global family health plans will not be directly affected by Sura’s plan to leave the EPS scheme. In fact, Sura states that its strategy is to focus entirely on its private plans.