Ley 100 and membership of an EPS

Colombia’s statutory health system, the Sistema General de Seguridad Social en Salud (SGSSS), was created by Ley 100 de 1993. People who can pay belong to the contributory regime (régimen contributivo), and people without the means to pay are covered by the subsidised regime. An employee therefore sits in the contributory regime.

Membership runs through a health promotion entity, an entidad promotora de salud (EPS). EPS affiliation instructions explain that the contributing member, the cotizante, lists their beneficiaries on the same form.

Foreign residents can join. A 2024 opinion from the health regulator, Supersalud, points to the affiliation documents set for foreigners in Decreto 780 de 2016. Foreigners with a visa of more than three months hold a cédula de extranjería issued by Migración Colombia, and the temporary protection permit (PPT) is also accepted.

How the contribution is split

Article 204 of Ley 100, as amended and in force in 2026, sets the health contribution at 12.5% of the contribution base: 8.5% from the employer and 4% from the worker. The base cannot be lower than the monthly minimum wage, and 1.5 points of the total fund the subsidised regime through a solidarity account. Check the current figure before you set up payroll.

The same article, read with article 114-1 of the tax code, exempts employers that are income-tax-paying companies from the 8.5% share for workers earning less than 10 monthly minimum wages. For pay at or above that level, the employer pays the full share, and the worker’s 4% is due in every case. An individual employer qualifies only with at least two workers. A Colombian tax publication walks through how this applies in 2026.

Who one membership can cover

Article 163 of Ley 100 lets a contributing member cover a spouse or permanent partner, children up to 25 who depend on them financially, and children of any age with a permanent disability. When there is no spouse, partner or child, dependent parents without a pension can be covered instead. Children aged 18 to 25 are presumed dependent unless they contribute to social security themselves.

For an employer that is a useful baseline: the household is already inside the statutory system, so any extra benefit adds to cover the family has rather than creating it.

Prepaid medicine and complementary plans

Colombian press and a university guide for foreign employees describe two add-ons that sit on top of EPS membership. Medicina prepagada is sold by companies that Supersalud authorises and supervises, while a plan complementario is sold by the member’s own EPS. Health insurance policies from insurers fall under a different supervisor, the Superintendencia Financiera.

The university guide adds that a person must already be affiliated with an EPS to buy either one, that both add to the mandatory system rather than replace it, and that a complementary plan has to come from the EPS the member already pays into, while prepaid medicine can come from any authorised company.

What the insurance regulator says about foreign insurers

The Superintendencia Financiera states that contracting insurance with unauthorised foreign insurers is prohibited, and that foreign insurers may not offer or advertise their services in Colombia or to its residents except in listed cases. Ley 1328 de 2009 opened only specific lines to foreign insurers, such as international maritime transport, international commercial aviation, space launches and goods in international transit, and those insurers must register with the regulator.

An insurance-library summary of article 61 of that law describes residents being able to buy some insurance abroad, but excludes insurance linked to the social security system, mandatory insurance, and insurance that requires proof of prior social security cover. Health cover for a Colombian employee therefore starts with the EPS, and a global plan is not something that can simply be sold into the country. Our overview of international health insurance for remote employees sets out how global plans fit in other places.

Your own entity, an EST or an EOR

Colombia has a legal model for third-party employment, the empresa de servicios temporales (EST) under Ley 50 de 1990 and Decreto 1072 de 2015. The EST is the employer of the workers it places, but a 2019 Labour Ministry concept describes a limit: the same worker may serve the same client for at most one year, six months plus a six-month extension, and the client can be fined for going past it.

That cap rules the EST model out as a permanent setup for a long-term hire, and no EOR arrangement should be treated as an easy fix either. A Colombian labour lawyer or tax professional can tell you whether your own entity or an EOR suits the role, and whether the employer exemption reaches the legal employer you end up with. Our page on health coverage for EOR employees and contractors abroad compares employees and contractors in general terms.

Getting an introduction

Tell us through the form on this page which Colombian city your team works from, how many people it includes, whether beneficiaries are on their EPS membership, and whether you hire through an entity or an EOR. We forward those details to a benefits partner that handles international and remote-team health coverage, and the partner and the insurer decide eligibility, plans and pricing. For the full set of benefits topics, see employee benefits for small businesses.

A few useful answers

Common questions

How does an employee in Colombia get health cover?

By joining the contributory regime of the SGSSS through an EPS, a health promotion entity. The contributing member lists their beneficiaries on the same affiliation form.

How is the Colombian health contribution split?

Article 204 of Ley 100, as in force in 2026, sets 12.5% of the contribution base: 8.5% from the employer and 4% from the worker. Income-tax-paying companies are exempt from the employer share for workers earning under 10 monthly minimum wages. Check the current figure.

Can a foreign national join an EPS?

Yes. Foreign residents can affiliate using the documents set for foreigners in Decreto 780 de 2016, such as the cédula de extranjería issued by Migración Colombia, and the temporary protection permit (PPT) is also accepted.

Can prepaid medicine replace EPS membership?

No. A person needs EPS membership before buying medicina prepagada or a plan complementario, and both add to the mandatory system.

How long can a staffing company place the same worker with one client?

Under the EST model, a 2019 Labour Ministry concept describes a limit of one year with the same client, six months plus a six-month extension, and the client can be fined for exceeding it.

International Health Insurance for Remote Employees in Colombia