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Odontoprev was founded in 1987 by dental care professionals who identified a business opportunity in providing dental benefits to corporate clients that had a history of providing dental benefits to their employees and that demanded a high degree of professionalism and quality.
On August 1998, Private Equity Fund investors, acquired the control of Odontoprev. This association contributed significantly to our strategic position as a leader in the dental care sector and enabled us to develop innovative Corporate Governance practices for the healthcare industry in Brazil.
In 1999, we acquired Unidont (which at the time had approximately 84,000 members), increasing our membership base to 224,316 members.
In 2000, we merged Unidont into our company and acquired Clidec (which at the time had approximately 115,000 members), increasing our membership base to 446,750 members.
On December 1st, 2006, Odontoprev completed initial public offering, raising R$171.411 million, net of placement expenses carried out in 2006. The primary public offering totaled 6,650,000 shares at a par value of R$28.00 per share, with an initial batch of 5,782,609 shares added to the 867,391 share from the supplementary batch (greenshoe).
With this operation, 18,643,973 shares were sold at a par value of R$28.00 per share, resulting R$522.031 million. Thus, Odontoprev became a company with fragmented control, with a free-float of 84.2% of its shares.
On February 9th, 2007, after the approval of the ANS – National Supplementary Health Agency, OdontoPrev concluded the acquisition of DentalCorp quotas for R$25,244 thousand. DentalCorp is commercially focused on small and middle size companies and, according to ANS data, had 190,646 members in March 2007.
On April 4th, 2007, Private Equity investors sold their Odontoprev holdings, amounting to 2,741,312 shares, marking their withdrawal from the Company.
On October 8th, after the approval from ANS, the acquisition of Rede Dental was completed. On September 30th, 2007, Rede Dental had 109,596 members.
On February 18th, 2008, the Care Plus Group, one of the leaders on medical plans and dedicated to the premium segment, and Odontoprev, the largest dental plan operator in Brazil, announced a strategic alliance in oral health. The agreement between the parties began with the acquisition by Odontoprev of 100% of Care Plus Dental Ltda, Biodent Assistência Odontológica S/A e S.R.J.S.P.E Empreendimentos e Participações Ltda, for R$ 29,670 thousand. On June 30th, 2008, Care Plus had 72,329 members.
On July 8th, 2008, Odontoprev Serviços, a subsidiary of Odontoprev S/A, exercised its option to buy the control of Easy Software, the leading company in the field of management software for dental offices, dental clinics and dental benefit companies. The acquisition price for 51% of Easy Software capital was R$3.1 million.
On September 1st, 2008, Odontoprev exercised its option to buy Sepao Assistência Odontológica Empresarial Ltda. The basic price for Sepao was R$9 million, of which R$1 million was paid cash on June 25th, 2008. On October 31st, 2008, ANS approved the acquisition of Sepao.
On January 8th, 2009, ANS Approved the acquisition of Prontodente.
On March 9th, March 2009, ANS approved the acquisition of OdontoServ and ADCON.
On November 14th, 2008, Dental Partner Comércio de Produtos e Equipamentos Ltda. was created controlled by Clidec – Clinica Dentária Especializada Cura D‘ars Ltda., with operations starting in June 2009.
On October 18th, 2009 Odontoprev‘s Board of Director approved the Association Agreement with Bradesco Dental S.A., a wholly-owned subsidiary of Bradesco Saúde S.A.. This agreement addresses the combination of the dental plan operation of both companies. Such combination occurred by means of the merger of shares of Bradesco Dental into Odontoprev.
After approval of the National Health Agency (ANS) on December 23th, 2009, Odontoprev incorporated Bradesco Dental. The EGM of July 1st, 2010 approved the merger of Bradesco Dental by OdontoPrev.
On August 19th, 2010, Odontoprev signed Memorandum of Understanding, without binding effect, with BB Seguros S.A. (BB Insurance), Bradesco Seguros S.A. (Bradesco) and ZNT, aiming to form a strategic alliance for the development and commercialization of dental plans. The alliance involves studies to create a company with 75% of total capital (49.99% of voting shares and 100% of preferred capital) of BB Seguros and 25% of total capital (50.01% of voting ) of Odontoprev. Will be made available on an exclusive distribution channels on Banco do Brasil (BB) branches the marketing of dental plans of Odontoprev for a period of 20 years, including the hiring of dental plans for employees BB and their dependents.
On November 16th, 2010 Odontoprev signed a non-binding MOU with BB Seguros Participações S.A. (“BB Seguros”), aiming to develop dental benefits to Banco do Brasil employees, retirees and family members. Also a JV will be created, to explore the opportunity to sell dental benefits within the Banco do Brasil distribution channels.
Despite the existence of the provisional agreement, the consummation of the transaction is subject to technical, legal and financial studies, to the signature of definitive documents and completion of legal formalities and regulatory requirements.
Focused on the dental value chain, on September 28th 2012, Odontoprev acquired in partnership with Grupo Fleury, Grupo Papaiz, a leading dental diagnostics company in São Paulo. Odontoprev controls 49% of the Company.
On June 11, 2013, Odontoprev signed an Association Agreement with Banco do Brasil, BB Seguros Participações S.A. and BB Corretora de Seguros Administradora de Bens S.A, with the objective of, through a new company named Brasildental Operadora de Planos Odontológicos S.A. (Brasildental), developing and promoting, and through BB Corretora, distributing and commercializing dental plans under the brand BB Dental, with exclusivity in all of BB’s distribution channels in Brazil, for twenty (20) years and may be extended for equal periods. Brasildental’s initial corporate capital shall be of R$5 million, distributed in 100,000 common shares and 100,000 preferred shares, with the following ownership structure: (i) BB Seguros shall hold 49.99% of the common shares and 100% of preferred shares, representing a 74.99% ownership of the total capital, and (ii) Odontoprev shall hold 50.01% of the common shares, representing 25.01% of the total corporate capital. BB Seguros and Odontoprev shall be liable for the constitution of Brasildental’s initial capital in proportion to their respective holdings. On August 05th, 2013 the Administrative Council for Economic Defense (CADE) approved the agreement.
On October 14th, 2013, Bradesco Saúde and Randal Zanetti contracted the terms and conditions of a restructuring in their respective equity interests as well as a strategic consolidation which 1) the indirect acquisition, by Bradesco Saúde, and the sale by Randal, of equity interest in Odontoprev representing 6.5% of its total and voting corporate capital, 2) the proposal to change the CEO of the Company, which office, after approval by the Company’s Board of Directors, will no longer be occupied by Randal and will be occupied by Mr. Mauro Figueiredo, 3) Randal will, after approval by the shareholders meeting, be appointed as Deputy Chairman of the Company’s Board of Directors, and 4) the current shareholders agreement of the Company will be terminated and Randal will remain as direct shareholder of the Company, holding an equity interest equivalent to, approximately, 1% of its total and voting corporate capital. The effectiveness of the Restructuring is subject to the fulfillment of the legal and regulatory applicable requirements.
On August 25, 2014, in addition to the Material Facts dated on August 19th, 2010, on June 11th, 2013 and on August 5th, 2013, and the Notice to the Market released on March 12th, 2014, the Company informed that: 1- Due to the fulfillment of all precedent conditions provided in the Agreement signed on June 11th, 2013 (“Acordo de Associação e Outras Avenças” or “Acordo de Associação”) by Odontoprev S.A. (“Odontoprev”), Odontoprev Serviços Ltda, BB Seguros Participações S.A. (“BB Seguros”), BB Corretora de Seguros e Administradora de Bens S.A. (“BB Corretora”) and Banco do Brasil S.A., the referred Parties signed the final documents of the partnership on August 22nd, 2014; 2- Thus, Brasildental Operadora de Planos Odontológicos S.A. (“Brasildental”) joined the “Acordo de Associação”, becoming a Part of the Agreement, while Odontoprev and BB Seguros signed the Shareholders Agreement (“Acordo de Acionistas”) of Brasildental. The Parties hereby clarified that began the commercial operations on this date.
On December 30, 2014, Odontoprev S.A. was informed by Bradesco Saúde S.A. about the incorporation of its subsidiaries, Santa Rita de Cássia Empreendimentos, Comércio e Participações S.A., indirect shareholder of the Company, and ZNT Empreendimentos, Comércio e Participações S.A., direct shareholder of the Company. The total capital of the subsidiaries was wholly state owned by Bradesco Saúde. As a result, OdontoPrev informs that accordingly to art. No 12 of CVM instruction 358, Bradesco Saúde became the holder, given the incorporation of its subsidiaries and the sucession of its rights and obligations, of direct participation on OdontoPrev to 265,648,397 ordinary shares, representing 50.01% of total capital of the Company.
On April 27, 2016, the Board of Directors registered the resignation letter of Mr. Mauro Figueiredo, CEO, and appointed Mr. Rodrigo Bacellar to the same position. The change took place on June 1st, 2016. At the same meeting, members of Audit Committee and Human Resources Committee were reelected.
On August 06, 2018 it was approved the acquisition of Odonto System, a dental-only company, with 641 thousand beneficiaries and revenues of R$101 million in 2017.
On January 02, 2019, it was approved the incorporation of Odonto System at the Extraordinary General Meeting.
On January 04, 2021, it was approved the incorporation of Rede Dental, at the Extraordinary General Meeting.
On June 16, 2021, it was approved the acquisition of Mogidonto Planos Odontológicos Ltda., with headquarters in Mogi das Cruzes/SP, and the acquisition, through its subsidiary, Clidec, of Boutique Dental Ltda., with headquarters in Mogi das Cruzes/SP.
On January 03, 2022, it was approved the incorporation of Mogidonto, at the Extraordinary General Meeting.
On August 16, 2022, Odontoprev informs an increase in the participation of Healthtech MaChiron.
On October 03, 2022, conclusion of the purchase of the remaining shares of Odontored, in Mexico.
About Odontoprev
Odontoprev, listed in São Paulo since 2006, is the leading dental benefits provider in Latin America, with about 9.0 million beneficiaries. The dentist network is specialized, with an accredited network of 27 thousand. The Company is a signatory of the UN Global Compact since 2008, and is committed through the Cabron Neutral project to annually neutralize its Greenhouse Gas emissions since the foundation, in 1987. The Company is a member of the Novo Mercado at B3, and has shareholders from more than 30 countries.
Odontoprev on 1 pageDental Market
According to the ANS, the private healthcare industry in Brazil includes approximately over 1,146 providers with registered members, tens of thousands of certified doctors, dentists and other health professionals, hospitals, laboratories, and clinics. In september 2022 , approximately 50.2 million Brazilians were members of private healthcare plans and 30.5 million were members of dental plans.These Brazilians use private healthcare plans for office visits, exams and/or hospital stays, depending on their contracts and coverage.
According to the latest figures released by ANS, revenues from all types of private and insurance health plans in Brazil has reached approximately R$119 billion in the second quarter of 2022.
Following the reform of higher education in Brazil in the 1980s and 1990s, several new dental schools opened throughout the country from which thousands of professionals graduate each year. According to the Federal Dental Care Council (Conselho Federal de Odontologia), there are currently approximately 638 dental schools in the country and approximately 383,000 certified dentists.
Despite the fact that Brazil has a large number of certified dentists and a population that exhibits unusually high attention to its oral health (evidenced by a high consumption of oral health products per capita that is on par with that of certain first world countries), access to dental care remains limited. This is particularly due to the lack of efficient management and finance mechanisms. This lack of access to dental care created an opportunity for dental plan companies that had access to capital and management know-how. As a result, after the second half of the 1990s, the dental plan industry has grown consistently, representing a new alternative form of access to oral healthcare.
Although the dental care plan industry is almost as old as the medical care plan industry, it was only in the late 1980s, when dental plans began to provide better and more reliable services, that they became an attractive benefits option for large employers.
As opposed to the medical care industry, where individuals have the alternative of government provided services, dental services were only offered by dentists acting as simple service providers without the assistance of any management or financing mechanisms.This model, which was aimed at an elite segment of the population, allowed for the provision of highly technical and scientifically advanced dental care with sophisticated and expensive resources. However, it was restricted to the segment of the population that could afford high prices and direct payment.
The main factors that have driven the growth of the dental care industry have been:
- The structural imbalance between the supply and demand of services: Brazil is one of the countries with the highest number of available dental professionals, but it is also the country in which a large part of the population has no access to their services due to a lack of financing and management mechanisms;
- The lack of a public service alternative: the low availability and quality of government-provided dental care services leaves most of the population without access to dental care services;
- The growing inclusion of dental plans in the benefits packages of corporations: these plans were initially restricted to large corporations. However, the provision of dental benefits is continuously growing in small- and medium-sized companies, and is already the fourth most common benefit offered by organizations according to Towers Perrin, a company that specializes in employee benefits for large corporations;
- The opportunities created by the growing interest from new distribution channels: such as insurance brokers and benefits consultants; and
- Regulations: that have been promoting the development of the industry as a whole through the reduction of the number of informal providers and the introduction of better management and care practices.
- Growth in the membership base and low penetration: according to the ANS, the exclusive dental plan industry grew from 7.3 million members in 2006 to 30.5 million in september 2022, representing a compound annual growth rate of 10% in that period. In 2006, enrollment in dental care plans represented approximately 20% of the total number of healthcare plan members in the country. This number had grown to approximately 51% in september 2022. Despite this growth, the enrollment percentages are still very low in comparison with more mature markets like the United States which we believe represent a significant growth potential.
- Consolidation potential: with 408 active providers in september 2022 according to the ANS, the dental plan industry is going through a period of consolidation.
- Regional growth potential: 59% of all dental plan members are located in the southeastern region of Brazil , followed by 19% in the northeastern region, and 11% in the south. The state of São Paulo alone accounts for almost 36%. Thus, there is significant growth potential in those states and regions where the presence of dental care providers is still relatively low.
- Group contracts: the dental plan segment is mainly made up of group plans, which represent more than 82% of all plans sold in the segment. This characteristic provides more flexibility in establishing initial prices as well as freedom in direct negotiations of price increases with the contracting party.
- Predominance of group dentistry: the largest sub-segment within the dental plan segment is group dentistry, followed by group medicine. Group dentistry has also been the most dynamic segment representing 42% of total revenues of dental plan.
- Favorable risk profile: the risk profile of dental care is different in important aspects from the risk profile of medical care. Medical care costs increase with the aging of health plan members as well as with the introduction of new, more expensive and non-replaceable technologies. In contrast, dental care costs – generally and particularly in Brazil today where plan growth is the result of the addition of new population segments with no history of previous coverage – increase substantially during the beginning of a contract period since the demand for dental care had previously been unfulfilled. After this initial peak, the cost of dental care diminishes until it reaches a maintenance level that tends to remain stable regardless of the age of the population. The attainment of this maintenance level and improved management of evolving care costs is due to factors such as:
(i) new technologies that tend to replace previous technologies without entailing large cost increases;
(ii) more effective programs and procedures to prevent illness and promote health;
(iii) the absence of unexpected major and costly accidents or events that require dental treatment;
(iv) changes in pathologies and treatments for aging members do not entail cost increases; and
(v) the reduced costs and lower demand for the resources required to identify pathologies.
The dental plan markets in Brazil and the United States have important similarities. Additionally, a significant part of the dentistry practices in Brazil are strongly influenced by, and mirror the practices employed in, the United States. The main similarities between the two markets are:
- Private system base: as opposed to other countries, dental care provision in the United States and Brazil is based on a private system, as public services are insufficiently available;
- Network-based care model: although there are some differences, the group dentistry model in Brazil and the Dental Preferred Provider Organization, or DPPO, model in the United States are both the leading and fastest growing dental care models in each of such markets; and
- Benefits industry focus: in both countries, the main driver of growth has been the increasing demand for and the growing importance of dentistry in benefit packages offered by corporations to their employees.
- Despite these similarities, certain differences are also significant when comparing the two markets, such as.
- Availability of dental care professionals: the number of available dentists is considerably larger in Brazil, and contrary to the trend in the United States, the number is increasing;
- Verticalization: in the United States, providers focus on a few levels in the value chain with high specialization. In Brazil, on the other hand, operations tend to be more integrated, often including sales, risk-taking and health management. This characteristic has the potential to aggregate profit margins generating higher bottom-line income than in the United States; and
- Operation and market penetration scale: in the United States the penetration of dental plans is reaching its maturity, with growth basically following the population growth, and reaching approximately 52% of medical plan members and 47% of the population. In Brazil, even if we consider differences in income, we believe that the dental care plan industry is still in the initial stages of growth with penetration reaching 51% of medical plan members and approximately 12% of the population.
REGULATION OF THE DENTAL PLAN SEGMENT IN BRAZIL
The Brazilian Federal Constitution grants Brazilian citizens a number of basic rights including the right to health. In order to ensure this right, the Brazilian Constitution created the Sole Health System (Sistema Único de Saúde), or SUS, which is the public healthcare system in Brazil, allowing the private sector to take part in the provision of healthcare on a supplementary basis. The direct or indirect interest of foreign companies or foreign investments in the health care industry is forbidden by the Brazilian Constitution, except when the law otherwise provides.
The Brazilian government also drafted the Private Healthcare Plan Law, which defines the rules that govern private health plans, and establishes standards for the creation, organization, operation, and inspection of providers. This law allows for foreign individuals or legal entities to hold interests in providers.
The Private Healthcare Plan Law also requires that private healthcare providers reimburse the SUS for services provided by public or private institutions that are part of the public healthcare system to individuals who are also members of private healthcare plans.
In order to improve the regulating role of the government in the private health sector, on January 28, 2000, the Brazilian government issued Law No. 9,961, which created the ANS and made the agency responsible for defining the rules and regulations applicable to private companies active in the healthcare industry.
The ANS is connected to the Ministry of Health by means of a management contract that establishes the goals and standards to be followed by the ANS and that must be approved by the Conselho de Saúde Suplementar (Supplementary Health Council or CONSU). The ANS is the government agency responsible for drafting all legislation related to the health industry and supervising the activities of its participants. It is independent to draft such legislation and enjoys budgetary autonomy. Private healthcare providers are also subject to all other national, state and municipal laws.
Since its creation, the ANS has been establishing specific standards for the private/supplementary health industry by means of specific rules that must be followed by all companies operating in this industry, including the following:
- Providers with more than 20,000 members must, for example, submit their books to independent auditors registered at the Regional Accounting Council (Conselho Regional de Contabilidade), or CRC, and the CVM. They must then publish their results, each year, together with financial statements kept in accordance with ANS Normative Resolution No. 9 of February 14, 2007;
- Providers are prohibited from engaging in any financial transactions with (i) their management as well as members of the board of directors, fiscal and consulting committees or similar bodies; (ii) the spouses and relatives up to second degree of the persons mentioned in item (i) above; or (iii) any company in which the persons mentioned in item (i) above or (iv) any company in which the persons mentioned in items (i) and (ii) hold an interest, provided such persons, jointly or separately, own a controlling interest in that company. If healthcare providers engage in such transactions, their executives will be personally liable for losses incurred by them; and
- Providers are not subject to bankruptcy laws but may be subject to extrajudicial liquidation. In the case of the latter, the court may demand the establishment of a fiscal management regime if the provider experiences serious financial difficulties.
ANS regulations also relate to several other issues such as the minimum requirements for the establishment, operation and termination of providers; minimal required claim reserves; account plans; healthcare fees; management of member information; coverage standards and healthcare quality; specific and mandatory requirements related to healthcare plans that must be considered in the formation of every contract entered into by providers and the definitions contained in them; minimum coverage; prices for different age groups; means of access to benefits (modalities such as individual and/or family, company group or collective adhesion); means of access to treatment (access exclusively for the members of an accredited network or access modalities in which the individual is free to choose the provider); regulation mechanisms; waiting periods before benefits can be enjoyed and the territorial coverage of each benefit plan.
In addition, any transfer of control of providers is subject to ANS‘s prior approval. Our future acquisitions may be subject to approval by Brazilian antitrust and health agencies which could result in delays or unexpected expense and which could have a material adverse effect on our results of operation.
OdontoPrev and its subsidiaries Clidec, Rede Dental and Sepao are providers. According to ANS Resolution RDC No. 39, dated October 27, 2000, OdontoPrev, Rede Dental and Sepao are dental care providers of the tertiary dental care segment, which is applicable to providers that spend in their proprietary facilities less than 10% of the total dental care costs from services related to dental plans. OdontoPrev does not own a proprietary facility. Clidec is a dental care provider of the proprietary dental care segment, which is applicable to providers that spend in their proprietary facilities more than 30% of the total dental care costs from services related to dental plans.
We understand that the Private Healthcare Plan Law and ANS‘s regulations support the provision of private healthcare plans in the proprietary dental care segment (where the provider directly provides dental care in accordance with ANS Resolution RDC No. 39) by an entity controlled by foreign investments, as is the case of Clidec. Any understanding to the contrary would not cause a material adverse effect in our financial condition or results of operation since our activities are not focused on the proprietary dental care.
According to the Private Healthcare Plan Law, benefit plans are classified into four specific categories: outpatient, obstetrics, in-patient, and dental, which may be offered separately or combined. ANS regulations require that all providers offer a plan that covers a minimum set of benefits. Medical and dental plan providers (with the exception of self-management providers that provide free plans and exclusive dental care providers) must observe the minimums applicable to the laboratory and hospital, and to the dental sector, respectively.
The ANS currently focuses on companies that consider themselves health plan providers for individuals and/or families. This is because the user in this category is the weakest party in the relationship with the provider from the perspective of the Consumer Protection Code.
ANS regulations focus primarily on medical care, rather than dental care industry, due to the fact that public healthcare in Brazil is insufficiently available and regulations are recent.
According to the ANS, we are classified as a provider operating solely in the dental care industry, focused on the group and corporate plan market, which negotiations are carried out between us and corporations, and our fees are paid by the corporations through monthly invoices, as well as individual plans. We do not have to wait for ANS approval to readjust monthly benefit plan rates considering: a) group plans are sponsored by contracting corporations, we just have to comunicate de percentage of readjust b) individual plans are readjusted by official inflation index released by an external institution.
All of our benefit plans are filed with the ANS and offer, at a minimum, coverage for the list stipulated by the ANS in Normative Resolution nº. 154 of June 05, 2007.
Purpose and values
Purpose
To promote high-quality dentistry.
Values
A healthy ecosystem is one in which everyone wins
Challenges are opportunities
Trust is something built each and every day
Quality is more than just slip service
Evolving is the way we achieve growth