Within the SGSSS the reform created two parallel insurance schemes to target different sectors of the population—a Contributive Regime (CR), which targets the higher income population, and a Subsidized Regime (SR), which targets the lower income population. The CR is mandatory for all formal workers who earn at least one minimum salary per month for informal workers who earn at least two minimum salaries per month. The contribution for formal employees is 12.5% of their monthly wage; 8.5% is paid by employers and 4% is paid by employees. The self-employed (or informal workers) must pay the entire 12.5% contribution.
The second scheme is the Subsidized Regime (SR), which was designed for the poor and indigent population. This target population is identified through the Selection System of Beneficiaries for Social Programs (SISBEN in Spanish), which is a proxy-means test designed to identify the most vulnerable members of a municipality. This SISBEN index is calculated at the household level through the use of a questionnaire. There are six score levels, 1 being the poorest. Levels 1 and 2 qualify for the SR, while level 3 may qualify in some municipalities that choose to contribute out of their own coffers, at the local governments discretion.
Of the 12.5% total contribution per individual to the Contributory Regime, the FOSYGA channels 1.5% into the Subsidized Regime (SR) as a solidarity contribution, while the remaining 11% stays in the CR. Thus, FOSYGA provides cross-subsidies between the wealthy and the poor, the sick and the healthy, and the old and the young.
A third prong to the provision of services is the Basic Health Plan (PBS in Spanish). This plan is a safety net financed by general taxes that is composed of public hospitals and health centers. While all citizens are eligible to receive the benefits under this plan, it primarily serves those who have not yet been enrolled in either the CR or the SR and those who are enrolled in the SR but require services that are not yet covered under its benefits package.