|
Triple-S Management Corporation
|
|
|
1441 F.D. Roosevelt Ave.
|
|
|
San Juan, PR 00920
|
|
|
www.triplesmanagement.com
|
|
|
FOR FURTHER INFORMATION:
|
|
|
AT THE COMPANY:
|
INVESTOR RELATIONS:
|
|
Victor J. Haddock-Morales
|
Mr. Garrett Edson
|
|
EVP and Chief Financial Officer
|
ICR
|
|
(787) 749-4949
|
(787) 792-6488
|
Triple-S Management Corporation Reports Third Quarter 2021 Results
SAN JUAN, Puerto Rico, November 4, 2021 – Triple-S Management Corporation (NYSE:GTS), a leading healthcare services company in Puerto Rico, today
announced its third quarter 2021 results.
Roberto Garcia-Rodriguez, President and Chief Executive Officer, commented: “We had a solid third quarter performance as we continued to record
double-digit revenue growth year-over-year, driven by our Medicaid offering along with solid growth at our Life and P&C segments. Moving forward, we continue to progress in our integrated healthcare strategy, enabling us to deliver additional
attractive products, along with the high-quality care and superior service to which our members have become accustomed.”
Third Quarter 2021 Consolidated Results and Other Highlights
| • |
Net income of $8.2 million, or $0.35 per diluted share, compared with $23.6 million, or $1.02 per diluted share, in the prior year period.
|
| • |
Adjusted net income of $9.6 million, or $0.41 per diluted share, versus $14.2 million, or $0.61 per diluted share, in the prior-year period.
|
| • |
Operating revenue of $1.0 billion, a 10.8% increase from the prior-year period, primarily reflecting higher Managed Care net premiums earned.
|
| • |
Consolidated loss ratio of 86.2%, an increase of 370 basis points compared with the third quarter of 2020, reflecting normalized Managed Care utilization patterns
in the third quarter of 2021.
|
| • |
Medical loss ratio (MLR) of 88.7%, 400 basis points higher than the same period last year.
|
| • |
Consolidated operating income of $11.5 million, compared with $22.3 million in the prior-year period.
|
1
Triple-S Management Corporation
Selected Segment Quarterly Details
Managed Care
| • |
Managed Care premiums earned were $939.7 million, up 10.6% year-over-year.
|
| o |
Medicare premiums earned were $423.1 million, an increase of 5.6% from the prior-year period. The increase was largely due to higher premium rates resulting from a
rise in the premium rate benchmark and membership risk score and higher enrollment.
|
| o |
Medicaid premiums earned were $302.2 million, an increase of 25.4% from the prior-year period, primarily reflecting an increase in enrollment of approximately
210,000 member months and higher average premium rates. In addition, following a reconciliation process with ASES this quarter, the Company recognized premiums corresponding to prior periods. These increases were partially offset by the
elimination of the HIP fee pass-through in 2021.
|
| o |
Commercial premiums earned were $214.4 million, an increase of 2.9% from the prior-year period, mainly reflecting higher average premium rates in the 2021 period, partially offset by the elimination of the HIP fee pass-through in 2021.
|
| • |
Reported MLR was 88.7%, an increase of 400 basis points from the prior-year period, primarily reflecting the elimination of the HIP fee in 2021, normalized
utilization of services compared with the low utilization in the prior-year quarter due to the pandemic, higher costs associated with COVID-19-related testing, treatment costs and the waiver of medical and payment policies, and increased
benefits in the Medicare product offering in 2021.
|
| • |
Managed Care operating expenses were $109.4 million, a decrease of $15.5 million, or 12.4%, from the prior-year quarter, primarily reflecting the elimination of the
HIP fee in 2021 and lower business promotion expenses, partially offset by higher personnel costs. The segment operating expense ratio was 11.6%, a 300 basis-point improvement from the prior-year quarter.
|
| • |
Premiums earned, net were $55.1 million, a 10.0% increase from the prior-year period, resulting from higher sales across all lines of business, particularly in the
Individual Life and Cancer lines of business. Operating income was $5.6 million, compared to $5.7 million in the prior-year period.
|
Property and Casualty Segment
| • |
Premiums earned, net were $26.3 million, an increase of 10.0% from the prior-year period. The increase was primarily due to higher premiums in Personal Package,
Commercial Liability, Commercial Auto and Commercial Property products, partially offset by a decrease in Commercial Package products.
|
| • |
Operating income was $2.0 million, compared with $4.4 million in the prior-year period, primarily driven by higher losses and operating expenses in the 2021
quarter. Losses during the 2020 period were lower due to the COVID-19 pandemic.
|
Liquidity and Capital Resources
| • |
As of September 30, 2021, the Company had cash and cash equivalents of $122.7 million and investments of $1.9 billion on its consolidated balance sheet.
|
2
Triple-S Management Corporation
2021 Outlook and Conference Call
Due to the pending transaction with GuideWell Mutual Holding Corporation announced on August 24, 2021, the Company will not be hosting a conference
call or providing an updated outlook for the fourth quarter or full year 2021. The Company’s previously issued full year 2021 outlook should no longer be relied upon. Please visit the Investor Relations section of the Company’s website at http://investors.triplesmanagement.com for the latest releases and information.
3
Triple-S Management Corporation
About Triple-S Management Corporation
Triple-S Management, a health services company, serves more than 1 million customers in Puerto Rico, which represents nearly one-third of the island’s
population. With over 60 years of experience, it is the premier insurance and managed care brand, with the largest customer base and broadest provider networks on the island. Triple-S Management has the exclusive right to use the Blue Cross Blue
Shield name and mark throughout Puerto Rico, the U.S. Virgin Islands, Costa Rica, the British Virgin Islands and Anguilla, and offers a broad portfolio of managed care and related products in the commercial, Medicare Advantage and Medicaid
segments. Triple-S Management is also a well-known brand in the life insurance and property and casualty insurance segments in Puerto Rico, with strong customer relationships and a significant market share. For more information about Triple-S
Management, visit www.triplesmanagement.com or contact investorrelations@ssspr.com.
Non-GAAP Financial Measures
This earnings release presents information about the Company’s adjusted net income, which is a non-GAAP financial metric provided as a complement to
the results provided in accordance with accounting principles generally accepted in the United States of America (GAAP). A reconciliation of adjusted net income to net income, the most comparable GAAP financial measure, is provided in the
accompanying tables found at the end of this release.
Forward-Looking Statements
This document contains forward-looking statements, as defined in the Private Securities Litigation Reform Act of 1995. Forward-looking statements
include information about possible or assumed future sales, results of operations, developments, regulatory approvals or other circumstances. Sentences that include “believe”, “expect”, “plan”, “intend”, “estimate”, “anticipate”, “project”,
“may”, “will”, “shall”, “should” and similar expressions, whether in the positive or negative, are intended to identify forward-looking statements.
All forward-looking statements in this news release reflect management’s current views about future events and are based on assumptions and subject to
risks and uncertainties. Consequently, actual results may differ materially from those expressed here as a result of various factors, including all the risks discussed and identified in public filings with the U.S. Securities and Exchange
Commission (SEC).
In addition, the Company operates in a highly competitive, constantly changing environment, influenced by very large organizations that have resulted
from business combinations, aggressive marketing and pricing practices of competitors, and regulatory oversight. The following factors, if markedly different from the Company’s planning assumptions (either individually or in combination), could
cause Triple-S Management’s results to differ materially from those expressed in any forward-looking statements shared here:
| • |
Trends in health care costs and utilization rates
|
| • |
Ability to secure sufficient premium rate increases
|
| • |
Competitor pricing below market trends of increasing costs
|
| • |
Re-estimates of policy and contract liabilities and reserves
|
| • |
Changes in government laws and regulations of managed care, life insurance or property and casualty insurance
|
| • |
Significant acquisitions or divestitures by major competitors
|
| • |
Introduction and use of new prescription drugs and technologies
|
| • |
A downgrade in the Company’s financial strength ratings
|
| • |
Litigation or legislation targeted at managed care, life insurance or property and casualty insurance companies
|
4
Triple-S Management Corporation
| • |
Ability to contract with providers and government agencies consistent with past practice
|
| • |
Ability to successfully implement the Company’s disease management, utilization management and Star ratings programs
|
| • |
Ability to maintain Federal Employees, Medicare and Medicaid contracts
|
| • |
Volatility in the securities markets and investment losses and defaults
|
| • |
General economic downturns, major disasters and epidemics
|
This list is not exhaustive. Management believes the forward-looking statements in this release are reasonable. However, there is no assurance that the
actions, events or results anticipated by the forward-looking statements will occur or, if any of them do, what impact they will have on the Company’s results of operations or financial condition. In view of these uncertainties, investors should
not place undue reliance on any forward-looking statements, which are based on current expectations. In addition, forward-looking statements are based on information available the day they are made, and (other than as required by applicable law,
including the securities laws of the United States) the Company does not intend to update or revise any of them in light of new information or future events.
Readers are advised to carefully review and consider the various disclosures in the Company’s SEC reports.
5
Triple-S Management Corporation
Earnings Release Schedules and Supplemental Information
|
Condensed Consolidated Balance Sheets
|
Exhibit I
|
|
Condensed Consolidated Statements of Earnings
|
Exhibit II
|
|
Condensed Consolidated Statements of Cash Flows
|
Exhibit III
|
|
Segment Performance Supplemental Information
|
Exhibit IV
|
|
Reconciliation of Non-GAAP Financial Measures
|
Exhibit V
|
6
Triple-S Management Corporation
Exhibit I
Condensed Consolidated Balance Sheets
(dollar in thousands)
Unaudited
|
September 30,
2021
|
December 31,
2020
|
|||||||
|
Assets
|
||||||||
|
Investments
|
$
|
1,940,745
|
$
|
1,874,024
|
||||
|
Cash and cash equivalents
|
122,709
|
110,989
|
||||||
|
Premium and other receivables, net
|
496,477
|
488,840
|
||||||
|
Deferred policy acquisition costs and value of business acquired
|
255,010
|
248,325
|
||||||
|
Property and equipment, net
|
137,762
|
131,974
|
||||||
|
Other assets
|
238,963
|
234,266
|
||||||
|
Total assets
|
$
|
3,191,666
|
$
|
3,088,418
|
||||
|
Liabilities and Stockholders' Equity
|
||||||||
|
Policy liabilities and accruals
|
$
|
1,588,117
|
$
|
1,550,798
|
||||
|
Accounts payable and accrued liabilities
|
537,110
|
487,356
|
||||||
|
Short-term borrowings
|
-
|
30,000
|
||||||
|
Long-term borrowings
|
49,498
|
52,751
|
||||||
|
Total liabilities
|
2,174,725
|
2,120,905
|
||||||
|
Stockholders’ equity:
|
||||||||
|
Common stock
|
23,795
|
23,430
|
||||||
|
Other stockholders’ equity
|
993,879
|
944,800
|
||||||
|
Total Triple-S Management Corporation stockholders’ equity
|
1,017,674
|
968,230
|
||||||
|
Non-controlling interest in consolidated subsidiary
|
(733
|
)
|
(717
|
)
|
||||
|
Total stockholders’ equity
|
1,016,941
|
967,513
|
||||||
|
Total liabilities and stockholders’ equity
|
$
|
3,191,666
|
$
|
3,088,418
|
||||
7
Triple-S Management Corporation
Exhibit II
Condensed Consolidated Statements of Earnings
(dollar in thousands, except per share information)
Unaudited
|
For the Three Months Ended
|
For the Nine Months Ended
|
|||||||||||||||
|
September 30,
|
September 30,
|
|||||||||||||||
|
2021
|
2020
|
2021
|
2020
|
|||||||||||||
|
Revenues
|
||||||||||||||||
|
Premiums earned, net
|
$
|
1,019,696
|
$
|
922,934
|
$
|
3,016,012
|
$
|
2,657,366
|
||||||||
|
Administrative service fees
|
3,875
|
3,752
|
9,316
|
8,755
|
||||||||||||
|
Net investment income
|
17,572
|
14,168
|
46,178
|
42,294
|
||||||||||||
|
Other operating revenues
|
3,925
|
2,052
|
8,518
|
6,394
|
||||||||||||
|
Total operating revenues
|
1,045,068
|
942,906
|
3,080,024
|
2,714,809
|
||||||||||||
|
Net realized investment gains (losses)
|
1,015
|
507
|
3,746
|
(180
|
)
|
|||||||||||
|
Net unrealized investment (losses) gains on equity investments
|
(7,912
|
)
|
11,040
|
13,383
|
(17,428
|
)
|
||||||||||
|
Other income, net
|
11,085
|
1,811
|
19,047
|
6,217
|
||||||||||||
|
Total revenues
|
1,049,256
|
956,264
|
3,116,200
|
2,703,418
|
||||||||||||
|
Benefits and expenses
|
||||||||||||||||
|
Claims incurred, net of reinsurance
|
878,947
|
761,792
|
2,573,569
|
2,129,401
|
||||||||||||
|
Operating expenses
|
154,526
|
158,809
|
456,880
|
499,669
|
||||||||||||
|
Total operating costs
|
1,033,473
|
920,601
|
3,030,449
|
2,629,070
|
||||||||||||
|
Interest expense
|
2,016
|
2,096
|
6,225
|
5,813
|
||||||||||||
|
Total benefits and expenses
|
1,035,489
|
922,697
|
3,036,674
|
2,634,883
|
||||||||||||
|
Income before taxes
|
13,767
|
33,567
|
79,526
|
68,535
|
||||||||||||
|
Income tax expense
|
5,607
|
9,989
|
24,505
|
27,520
|
||||||||||||
|
Net income
|
8,160
|
23,578
|
55,021
|
41,015
|
||||||||||||
|
Net loss attributable to the non-controlling interest
|
7
|
3
|
16
|
20
|
||||||||||||
|
Net income attributable to Triple-S Management Corporation
|
$
|
8,167
|
$
|
23,581
|
$
|
55,037
|
$
|
41,035
|
||||||||
|
Earnings per share attributable to Triple-S Management Corporation:
|
||||||||||||||||
|
Basic net income per share
|
$
|
0.35
|
$
|
1.02
|
$
|
2.35
|
$
|
1.77
|
||||||||
|
Diluted net income per share
|
$
|
0.35
|
$
|
1.02
|
$
|
2.34
|
$
|
1.76
|
||||||||
|
|
||||||||||||||||
|
Weighted average of common shares
|
23,494,415
|
23,073,511
|
23,402,622
|
23,215,840
|
||||||||||||
|
Diluted weighted average of common shares
|
23,610,672
|
23,193,980
|
23,546,277
|
23,318,069
|
||||||||||||
8
Triple-S Management Corporation
Exhibit III
Condensed Consolidated Statements of Cash Flows
(dollar in thousands)
Unaudited
|
For the Nine Months Ended
|
||||||||
|
September 30,
|
||||||||
|
2021
|
2020
|
|||||||
|
Net cash provided by operating activities
|
$
|
100,699
|
$
|
223,681
|
||||
|
Cash flows from investing activities:
|
||||||||
|
Proceeds from investments sold or matured:
|
||||||||
|
Securities available-for-sale:
|
||||||||
|
Fixed-maturities sold
|
140,866
|
94,557
|
||||||
|
Fixed-maturities matured/called
|
18,271
|
37,450
|
||||||
|
Securities held-to-maturity - fixed-maturities matured/called
|
747
|
1,079
|
||||||
|
Equity investments sold
|
99,951
|
80,152
|
||||||
|
Other invested assets sold
|
19,652
|
13,231
|
||||||
|
Acquisition of investments:
|
||||||||
|
Securities available-for-sale - fixed-maturities
|
(129,066
|
)
|
(206,387
|
)
|
||||
|
Securities held-to-maturity - fixed-maturities
|
(751
|
)
|
(1,087
|
)
|
||||
|
Equity investments
|
(199,046
|
)
|
(201,324
|
)
|
||||
|
Other invested assets
|
(9,317
|
)
|
(25,442
|
)
|
||||
|
(Decrease) increase in other investments
|
(4,470
|
)
|
(3,924
|
)
|
||||
|
Net change in policy loans
|
(21
|
)
|
240
|
|||||
|
Net capital expenditures
|
(16,948
|
)
|
(52,549
|
)
|
||||
|
Capital contribution on equity method investees
|
-
|
(7,083
|
)
|
|||||
|
Net cash used in investing activities
|
(80,132
|
)
|
(271,087
|
)
|
||||
|
Cash flows from financing activities:
|
||||||||
|
Change in outstanding checks in excess of bank balances
|
20,594
|
16,814
|
||||||
|
Net change in short-term borrowings
|
(30,000
|
)
|
28,500
|
|||||
|
Proceeds of long-term borrowings
|
-
|
30,841
|
||||||
|
Repayments of long-term borrowings
|
(3,370
|
)
|
(2,760
|
)
|
||||
|
Repurchase and retirement of common stock
|
-
|
(14,980
|
)
|
|||||
|
Proceeds from policyholder deposits
|
12,594
|
21,586
|
||||||
|
Surrender of policyholder deposits
|
(8,665
|
)
|
(12,829
|
)
|
||||
|
Net cash (used in) provided by financing activities
|
(8,847
|
)
|
67,172
|
|||||
|
Net increase in cash and cash equivalents
|
11,720
|
19,766
|
||||||
|
Cash and cash equivalents, beginning of period
|
110,989
|
109,837
|
||||||
|
Cash and cash equivalents, end of period
|
$
|
122,709
|
$
|
129,603
|
||||
9
Triple-S Management Corporation
Exhibit IV
Segment Performance Supplemental Information
|
(Unaudited)
|
Three months ended September 30,
|
Nine months ended September 30,
|
||||||||||||||||||||||
|
(dollar in millions)
|
2021
|
2020
|
Percentage Change
|
2021
|
2020
|
Percentage Change
|
||||||||||||||||||
|
Premiums earned, net:
|
||||||||||||||||||||||||
|
Managed Care:
|
||||||||||||||||||||||||
|
Medicare
|
$
|
423.1
|
$
|
400.7
|
5.6
|
%
|
$
|
1,233.8
|
$
|
1,160.9
|
6.3
|
%
|
||||||||||||
|
Medicaid
|
302.2
|
240.9
|
25.4
|
%
|
916.7
|
682.9
|
34.2
|
%
|
||||||||||||||||
|
Commercial
|
214.4
|
208.4
|
2.9
|
%
|
631.0
|
605.3
|
4.2
|
%
|
||||||||||||||||
|
Total Managed Care
|
939.7
|
850.0
|
10.6
|
%
|
2,781.5
|
2,449.1
|
13.6
|
%
|
||||||||||||||||
|
Life Insurance
|
55.1
|
50.1
|
10.0
|
%
|
161.6
|
144.9
|
11.5
|
%
|
||||||||||||||||
|
Property and Casualty
|
26.3
|
23.9
|
10.0
|
%
|
76.9
|
66.9
|
14.9
|
%
|
||||||||||||||||
|
Other
|
(1.4
|
)
|
(1.0
|
)
|
(40.0
|
%)
|
(4.0
|
)
|
(3.5
|
)
|
(14.3
|
%)
|
||||||||||||
|
Consolidated premiums earned, net
|
$
|
1,019.7
|
$
|
923.0
|
10.5
|
%
|
$
|
3,016.0
|
$
|
2,657.4
|
13.5
|
%
|
||||||||||||
|
Operating revenues: 1
|
||||||||||||||||||||||||
|
Managed Care
|
$
|
951.7
|
$
|
858.2
|
10.9
|
%
|
$
|
2,810.6
|
$
|
2,473.7
|
13.6
|
%
|
||||||||||||
|
Life Insurance
|
61.9
|
57.0
|
8.6
|
%
|
181.5
|
165.5
|
9.7
|
%
|
||||||||||||||||
|
Property and Casualty
|
28.8
|
26.1
|
10.3
|
%
|
83.7
|
73.5
|
13.9
|
%
|
||||||||||||||||
|
Other
|
2.6
|
1.6
|
62.5
|
%
|
4.2
|
2.1
|
100.0
|
%
|
||||||||||||||||
|
Consolidated operating revenues
|
$
|
1,045.0
|
$
|
942.9
|
10.8
|
%
|
$
|
3,080.0
|
$
|
2,714.8
|
13.5
|
%
|
||||||||||||
|
Operating income (loss): 2
|
||||||||||||||||||||||||
|
Managed Care
|
$
|
8.5
|
$
|
13.0
|
(34.6
|
%)
|
$
|
34.5
|
$
|
56.5
|
(38.9
|
%)
|
||||||||||||
|
Life Insurance
|
5.6
|
5.7
|
(1.8
|
%)
|
17.8
|
20.2
|
(11.9
|
%)
|
||||||||||||||||
|
Property and Casualty
|
2.0
|
4.4
|
(54.5
|
%)
|
7.8
|
10.9
|
(28.4
|
%)
|
||||||||||||||||
|
Other
|
(4.6
|
)
|
(0.8
|
)
|
(475.0
|
%)
|
(10.6
|
)
|
(1.9
|
)
|
(457.9
|
%)
|
||||||||||||
|
Consolidated operating income
|
$
|
11.5
|
$
|
22.3
|
(48.4
|
%)
|
$
|
49.5
|
$
|
85.7
|
(42.2
|
%)
|
||||||||||||
|
Operating margin: 3
|
||||||||||||||||||||||||
|
Managed Care
|
0.9
|
%
|
1.5
|
%
|
-60
|
bp
|
1.2
|
%
|
2.3
|
%
|
-110
|
bp
|
||||||||||||
|
Life Insurance
|
9.0
|
%
|
10.0
|
%
|
-100
|
bp
|
9.8
|
%
|
12.2
|
%
|
-240
|
bp
|
||||||||||||
|
Property and Casualty
|
6.9
|
%
|
16.9
|
%
|
-1,000
|
bp
|
9.3
|
%
|
14.8
|
%
|
-550
|
bp
|
||||||||||||
|
Consolidated
|
1.1
|
%
|
2.4
|
%
|
-130
|
bp
|
1.6
|
%
|
3.2
|
%
|
-160
|
bp
|
||||||||||||
|
Depreciation and amortization expense
|
$
|
3.6
|
$
|
3.1
|
16.1
|
%
|
$
|
10.7
|
$
|
10.9
|
(1.8
|
%)
|
||||||||||||
1 Operating revenues include premiums earned, net, administrative service fees and net investment income.
2 Operating income or loss include operating revenues minus operating costs. Operating costs include claims incurred and
operating expenses.
3 Operating margin is defined as operating income or loss divided by operating revenues.
10
Triple-S Management Corporation
Managed Care Additional Data
|
Three months ended September 30,
|
Nine months ended
September 30,
|
|||||||||||||||
|
(Unaudited)
|
2021
|
2020
|
2021
|
2020
|
||||||||||||
|
Member months enrollment:
|
||||||||||||||||
|
Medicare Advantage
|
|
410,939
|
407,170
|
1,228,732
|
1,220,280
|
|||||||||||
|
Medicaid
|
1,342,953
|
1,132,626
|
3,972,136
|
3,278,098
|
||||||||||||
|
Commercial:
|
||||||||||||||||
|
Fully insured
|
966,002
|
966,906
|
2,871,788
|
2,920,460
|
||||||||||||
|
Self-insured
|
281,153
|
324,372
|
875,844
|
981,634
|
||||||||||||
|
Total Commercial
|
1,247,155
|
1,291,278
|
3,747,632
|
3,902,094
|
||||||||||||
|
Total member months
|
3,001,047
|
2,831,074
|
8,948,500
|
8,400,472
|
||||||||||||
|
Claim liabilities (in millions)
|
$
|
533.7
|
$
|
417.6
|
||||||||||||
|
Days claim payable
|
60
|
57
|
||||||||||||||
|
Premium PMPM:
|
||||||||||||||||
|
Managed Care
|
$
|
345.49
|
$
|
339.09
|
$
|
344.56
|
$
|
330.12
|
||||||||
|
Medicare Advantage
|
1,029.59
|
984.11
|
1,004.12
|
951.34
|
||||||||||||
|
Medicaid
|
225.03
|
212.69
|
230.78
|
208.32
|
||||||||||||
|
Commercial
|
221.95
|
215.53
|
219.72
|
207.26
|
||||||||||||
|
Medical loss ratio:
|
88.7
|
%
|
84.7
|
%
|
88.0
|
%
|
82.7
|
%
|
||||||||
|
Medicare Advantage
|
82.5
|
%
|
80.6
|
%
|
85.1
|
%
|
80.2
|
%
|
||||||||
|
Medicaid
|
95.2
|
%
|
94.0
|
%
|
92.1
|
%
|
92.7
|
%
|
||||||||
|
Commercial
|
91.9
|
%
|
81.9
|
%
|
87.9
|
%
|
76.1
|
%
|
||||||||
|
Adjusted medical loss ratio: 1
|
90.7
|
%
|
81.8
|
%
|
89.9
|
%
|
81.1
|
%
|
||||||||
|
Medicare Advantage
|
84.6
|
%
|
75.0
|
%
|
86.8
|
%
|
77.4
|
%
|
||||||||
|
Medicaid
|
99.2
|
%
|
90.9
|
%
|
95.6
|
%
|
91.1
|
%
|
||||||||
|
Commercial
|
90.5
|
%
|
83.8
|
%
|
87.8
|
%
|
76.5
|
%
|
||||||||
|
Operating expense ratio:
|
||||||||||||||||
|
Consolidated
|
15.1
|
%
|
17.1
|
%
|
15.1
|
%
|
18.7
|
%
|
||||||||
|
Managed Care
|
11.6
|
%
|
14.6
|
%
|
11.7
|
%
|
15.9
|
%
|
||||||||
1 The adjusted medical loss ratio accounts for subsequent adjustments to estimates, such as prior-period reserve developments and Medicare
premium adjustments, and presents them in their corresponding period.
11
Triple-S Management Corporation
Managed Care Membership by Business
|
Managed Care Membership by Segment
|
As of September 30,
|
|||||||
|
2021
|
2020
|
|||||||
|
Members:
|
||||||||
|
Medicare Advantage
|
136,459
|
136,135
|
||||||
|
Medicaid
|
449,474
|
385,344
|
||||||
|
Commercial:
|
||||||||
|
Fully insured
|
321,772
|
321,673
|
||||||
|
Self-insured
|
94,261
|
107,830
|
||||||
|
Total Commercial
|
416,033
|
429,503
|
||||||
|
Total members
|
1,001,966
|
950,982
|
||||||
12
Triple-S Management Corporation
Exhibit V
Reconciliation of Non-GAAP Financial Measures
|
Adjusted Net Income
|
||||||||||||||||
|
(Unaudited)
|
Three months ended
September 30,
|
Nine months ended
September 30,
|
||||||||||||||
|
(dollar in millions)
|
2021
|
2020
|
2021
|
2020
|
||||||||||||
|
Net income
|
$
|
8.2
|
$
|
23.6
|
$
|
55.0
|
$
|
41.0
|
||||||||
|
Less adjustments:
|
||||||||||||||||
|
Net realized investment gains (losses)
|
1.0
|
0.5
|
3.7
|
(0.2
|
)
|
|||||||||||
|
Unrealized (losses) gains on equity investments
|
(7.9
|
)
|
11.0
|
13.4
|
(17.4
|
)
|
||||||||||
|
Contingency accrual
|
-
|
-
|
-
|
(32.0
|
)
|
|||||||||||
|
Private equity investment income
|
8.4
|
0.2
|
10.8
|
3.9
|
||||||||||||
|
GuideWell transaction costs
|
(1.8
|
)
|
-
|
(1.8
|
)
|
-
|
||||||||||
|
Tax impact of non-GAAP adjustments
|
(1.1
|
)
|
(2.3
|
)
|
(6.8
|
)
|
14.0
|
|||||||||
|
Adjusted net income
|
$
|
9.6
|
$
|
14.2
|
$
|
35.7
|
$
|
72.7
|
||||||||
|
Diluted adjusted net income per share
|
$
|
0.41
|
$
|
0.61
|
$
|
1.52
|
$
|
3.12
|
||||||||
Adjusted net income is a non-GAAP financial metric and should not be considered a substitute for, or superior to, financial measures calculated in
accordance with GAAP. Management believes that the use of this adjusted net income and adjusted net income per share provides investors and management useful information about the earnings impact of realized and unrealized investment gains or
losses, as well as other non-recurring items impacting the Company’s results of operations. The Company estimates tax impact of net realized and non-realized gains (losses), private equity investment income and contingency accrual at the
applicable statutory tax rates. These non-GAAP metrics do not consider all the items associated with the Company’s operations as determined in accordance with GAAP. As a result, one should not consider these measures in isolation.