EPS Health Insurance Affiliation Form Colombia (Formulario de Afiliación a EPS)

An EPS Health Insurance Affiliation Form Colombia (Formulario de Afiliación a EPS) is a mandatory registration document through which a worker selects and enrolls in an Entidad Promotora de Salud (EPS) under the contributive regime (régimen contributivo) of the Sistema General de Seguridad Social en Salud (SGSSS) established by Ley 100 de 1993. Article 157 of Ley 100 de 1993 mandates universal health coverage for all residents of Colombia, with dependent workers affiliated through the contributive regime funded by employer and worker contributions.

The Colombian health system operates through two principal regimes under Ley 100 de 1993 as modified by Ley 1122 de 2007 and Ley 1438 de 2011. The régimen contributivo covers workers with formal employment contracts, independent workers with contribution capacity, and their eligible dependents (beneficiarios). The régimen subsidiado covers individuals without contribution capacity, funded through the Sistema General de Participaciones and solidarity contributions. Workers with an employment contract under the Código Sustantivo del Trabajo (CST) must be affiliated to the contributive regime — the employer contributes 8.5% and the worker contributes 4% of the monthly salary through the Planilla Integrada de Liquidación de Aportes (PILA).

The Constitución Política de 1991 establishes health as a fundamental right in Article 49, reinforced by the Corte Constitucional in Sentencia T-760 de 2008 which ordered thorough structural reforms to guarantee effective access to health services. Article 48 of the Constitution establishes social security as a mandatory public service (servicio público obligatorio) organized under principles of efficiency, universality, and solidarity.

The worker exercises free choice of EPS under Ley 100 de 1993 Article 153, selecting from the entities authorized by the Superintendencia Nacional de Salud (Supersalud). Major EPS in Colombia include Sura EPS, Sanitas, Nueva EPS, Compensar, Famisanar, and Salud Total — each must provide the Plan de Beneficios en Salud (PBS, formerly POS) established by the Ministerio de Salud y Protección Social through Resolución 244 de 2019. The PBS defines the thorough package of medical services, medications, procedures, and treatments that every EPS must deliver to its affiliates.

Decretoley 806 de 1998 regulates the affiliation process, establishing that the employer must register new workers with their chosen EPS before the first day of work. The affiliation form captures the worker's personal data, selected EPS, and eligible dependents (beneficiarios) — spouse or compañero/a permanente under Ley 54 de 1990, children under 25 years of age, children with disabilities regardless of age, and parents without income who depend economically on the worker.

The Ministerio de Salud y Protección Social oversees the health system through the Administradora de los Recursos del Sistema General de Seguridad Social en Salud (ADRES), created by Ley 1753 de 2015, which manages the financial flows between EPS, IPS (Instituciones Prestadoras de Servicios de Salud), and contribution collection. The Superintendencia Nacional de Salud (Supersalud) supervises EPS operations, financial solvency, and service quality under Ley 1122 de 2007.

Under Decreto 1406 de 1999, employer contributions and worker deductions are reported and paid through the PILA system — operators authorized by the Ministerio process monthly contributions from all employers. Late affiliation or contribution payments trigger sanctions from the UGPP (Unidad de Gestión Pensional y Parafiscales) under Ley 1607 de 2012, and the employer becomes directly liable for any medical costs incurred by the unaffiliated worker.

An EPS Health Insurance Affiliation Form Colombia is required whenever a new employment relationship begins and the employer must register the worker in the Sistema General de Seguridad Social en Salud. Under Decreto 806 de 1998 and Ley 100 de 1993 Article 157, affiliation must be completed before the worker's first day on the job — the employer bears full financial liability for medical costs incurred by a worker who has not been timely affiliated.

The affiliation form is needed when a worker begins a new employment contract — contrato a término indefinido under CST Article 45, contrato a término fijo under CST Article 46, or contrato por obra o labor determinada. The employer must request the worker's EPS selection and process the affiliation through the PILA system within the timeframes established by Decreto 1406 de 1999. First-time affiliates (who have never been in the contributive regime) require a new affiliation, while workers with previous EPS coverage require a traslado (transfer) from their prior EPS.

The form is required when a worker exercises the right to change EPS under Ley 100 de 1993 Article 153 and Decreto 3047 de 2013. Workers may transfer between EPS entities after a minimum permanence of 12 months (or 18 months for certain conditions), provided they submit the transfer request during the mobility windows established by the Ministerio de Salud y Protección Social. The new affiliation form documents the worker's selection and initiates the transfer process.

An EPS Affiliation Form is needed when a worker's family circumstances change and new dependents (beneficiarios) must be registered. Under Decreto 806 de 1998, eligible dependents include: the spouse or compañero/a permanente (under Ley 54 de 1990, requiring two years of cohabitation or a declaration ante Notaría), children under 25 who are students or economically dependent, children with disabilities regardless of age, and parents who depend economically on the worker and are not themselves affiliated to any EPS or pension system.

The document is required when an independent worker (trabajador independiente) affiliates voluntarily to the contributive regime under Ley 100 de 1993 Article 157 numeral 2. Independent workers pay the full contribution (12.5% of their ingreso base de cotización — IBC, with a minimum IBC of one SMLMV) directly through the PILA system.

An affiliation form is also needed when a worker returns to formal employment after a period of inactivity in the contributive regime. Workers who were previously in the régimen subsidiado must be transitioned to the contributive regime upon beginning formal employment, with the employer processing the affiliation change through PILA.

A valid EPS Health Insurance Affiliation Form Colombia under Ley 100 de 1993 and Decreto 806 de 1998 must contain the following elements to be processed through the PILA system and accepted by the selected Entidad Promotora de Salud.

Worker Personal Data: Full legal name, cédula de ciudadanía (for Colombian nationals) or cédula de extranjería (for foreign residents), date of birth, gender, blood type (grupo sanguíneo and RH factor), residential address, municipality (municipio) and department (departamento), phone number, and email address. The cédula number serves as the unique identifier in the BDUA (Base de Datos Única de Afiliados) maintained by the ADRES under Ley 1753 de 2015.

Employer Information: Full razón social, NIT (Número de Identificación Tributaria assigned by the DIAN), employer type (persona jurídica or persona natural), and registered address. The employer's PILA registration number verifies active enrollment in the social security contribution system under Decreto 1406 de 1999.

EPS Selection: The name and code of the EPS selected by the worker from the entities authorized by the Superintendencia Nacional de Salud (Supersalud). Under Ley 100 de 1993 Article 153, the worker has absolute freedom to choose any EPS operating in their municipality of residence. The form must specify whether the affiliation is a new enrollment (primera vez), a reactivation (reingreso), or a transfer from another EPS (traslado).

Affiliation Type: Classification as cotizante (contributor — the worker) or beneficiario (dependent). Workers with employment contracts are cotizantes in the contributive regime. The ingreso base de cotización (IBC) — the monthly salary used for contribution calculations — must be specified, with a minimum of one SMLMV (COP$1.423.500 for 2025 under Decreto 2292 de 2024).

Dependents (Beneficiarios): For each eligible dependent, the form must include: full name, relationship to the worker (cónyuge, compañero/a permanente, hijo/a, padre/madre), cédula or registro civil number, date of birth, and documentation supporting the relationship — registro civil de matrimonio for spouse, declaración de unión marital de hecho under Ley 54 de 1990 for permanent partner, registro civil de nacimiento for children, or certification of economic dependency for parents.

Contribution Details: The monthly salary or IBC, employer contribution rate (8.5%), worker contribution rate (4%), and the total monthly contribution (12.5% of IBC). For workers earning above four SMLMV, an additional 0.5% point is added to the worker's contribution under Ley 1607 de 2012 for the solidarity fund (Fondo de Solidaridad y Garantía — FOSYGA, now managed by ADRES).

Previous Affiliation History: Information about any prior EPS affiliation, including the name of the previous EPS, whether the worker was in the contributive or subsidized regime, and the effective date of the last affiliation. Workers transferring between EPS must comply with the minimum permanence period (12 months under Decreto 3047 de 2013) and mobility windows.

Forms-legal.com provides this EPS Health Insurance Affiliation Form Colombia template as a practical starting point for registering workers in the contributive health regime. Each employer should verify EPS availability in the worker's municipality with the Superintendencia Nacional de Salud and process the affiliation through an authorized PILA operator before the worker's first day of employment.

Declarations and Signatures: The worker's signature declaring the accuracy of all information provided, acknowledging the right to receive the Plan de Beneficios en Salud (PBS), and authorizing the 4% salary deduction for health contributions. The employer's signature or stamp confirming the employment relationship, salary, and commitment to timely contribution payments through PILA. Under Ley 1438 de 2011, fraudulent affiliation information may result in cancellation of coverage and administrative sanctions from Supersalud.