Profile: Triple-S Management Corp (GTS)

GTS on New York Consolidated

21 Nov 2014
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Triple-S Management Corporation (TSM), incorporated on January 17, 1997, is a managed care company in Puerto Rico, serving approximately 1,684,000 members across all regions. The Company offers a portfolio of managed care and related products in the commercial and Medicare markets. The Company serve a wide range of customer segments - from corporate accounts, federal and local government employees and individuals to Medicare and Medicaid recipients. The Company also offers complementary products and services, including life insurance, accident and disability insurance and property and casualty insurance. It is a provider of life insurance policies in Puerto Rico. On February 7, 2011, through its subsidiary Triple-S Salud, Inc. (TSS), the Company completed the acquisition of 100% interest of American Health (AH).

The Company is a holding company and operates through its subsidiaries AH, managed care organizations that provide health benefits services to subscribers through contracts with hospitals, physicians, dentists, laboratories, and other organizations; Triple-S Vida, Inc. (TSV), which is engaged in the underwriting of life and accident and health insurance policies and the administration of annuity contracts, and Triple-S Propiedad, Inc. (TSP), which is engaged in the underwriting of property and casualty insurance policies.

Managed Care

The Company through its subsidiaries TSS and AH, it offers a range of managed care products, including Health Maintenance Organization (HMO) plans, Preferred Provider Organizations (PPO) plans, Medicare Supplement, Medicare Advantage and Medicare Part D. The Company designs its products to meet the needs and objectives of a range of customers, including employers, professional and trade associations, individuals and government entities. Its customers either contracts with the Company to assume underwriting risk or they self-fund underwriting risk and rely on the Company for provider network access, medical cost management, claim processing, stop-loss insurance and other administrative services.

The Company offers the managed care plans, such as HMO, PPO, BlueCard, Medicare Supplement, Prescription Drug Benefit Plans and Administrative Services Only. The Company offers HMO plans that provide members with health care coverage for a fixed monthly premium in addition to applicable member co-payments. Health care services can include emergency care, inpatient hospital and physician care, outpatient medical services and supplemental services, such as dental, vision, behavioral and prescription drugs, among others. Members must select a primary care physician within the network to provide and assist in managing care, including referrals to specialists. The Company offers PPO managed care plans that provide its members and their dependent family members with health care coverage in exchange for a fixed monthly premium.

The BlueCard program offers these members in-network benefits through the networks of the other BCBS plans in the United States and certain United States territories. In addition, the BlueCard worldwide program provides its PPO members with coverage for medical assistance worldwide. It offers Medicare Supplement products, which provide supplemental coverage for many of the medical expenses that the Medicare Parts A and B programs do not cover, such as deductibles, coinsurance and specified losses that exceed these programs’ maximum benefits. The Company offers prescription drug benefits under Medicare Part D in its Medicare Advantage plans, as well as on a stand-alone basis. It also offers a Drug Discount Card for local government employees and individuals. The Drug Discount Card program is not insurance, but rather provides access to discounts from contracted pharmacies. As of December 31, 2011, it had enrolled approximately 26,521 members in the Drug Discount Card program. It also offers its PPO products on a self-funded or ASO basis, under which it provides claims processing and other administrative services to employers and the Puerto Rico Medicaid program.

The Company competes with Medical Card Systems Inc., Aveta Inc., Humana, Inc. and First Medical Health Plan, Inc.

Life Insurance

The Company offers a variety of life, accident, disability and health and annuity products in Puerto Rico through its subsidiary Triple-S Vida, Inc. (TSV). TSV markets in-home service life and supplemental health products through a network of company-employed agents. Ordinary life, cancer and dreaded diseases (Cancer line of business), and pre-need life products are marketed through independent agents. TSV is a distributor of life products in Puerto Rico. It is a home service company in Puerto Rico and offer guaranteed issue, funeral and cancer policies to the lower and middle income market segments directly to people in their homes. It also markets its group life and disability coverage through its independent producers.

The Company competes with Cooperativa de Seguros de Vida de Puerto Rico, AXA Equitable Life, Mass Mutual Financial Group, AFLAC and Trans-Oceanic Life Insurance Company.

Property and Casualty Insurance

The Company offers a range of property and casualty insurance products through its subsidiary Triple-S Propiedad, Inc. (TSP). Its predominant lines of business are commercial multi-peril, commercial property mono-line, auto physical damage, auto liability and dwelling policies. This segment’s commercial lines target small to medium size accounts. It maintains a reinsurance program as a means of protecting its surplus in the event of a catastrophe. During the year ended December 31, 2011, 41.2% of the premiums written in the property and casualty insurance segment were ceded to reinsurers.

The Company competes with Chartis Insurance Company, Universal Insurance, MAPFRE Corporation and Cooperativa de Seguros Multiples de Puerto Rico.

Company Address

Triple-S Management Corp

1441 F.D. Roosevelt Ave.,
P.O. Box 363628
SAN JUAN     00936
P: +1787.7494949
F: +1787.7494191

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