United States

Profile: Triple-S Management Corp (GTS)

GTS on New York Consolidated

29 Apr 2016
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Triple-S Management Corporation (Triple-S), incorporated on October 9, 1996, is a provider of life insurance policies. The Company offers a portfolio of managed care and related products in the commercial and medicare markets. The Company operates in three segments: Managed Care, Life Insurance, and Property and Casualty Insurance. The Company markets its managed care products through a network of independent agents and brokers located throughout Puerto Rico. The Company provides administration services only or self-insured (ASO) managed care services to Plan de Salud del Gobierno (similar to Medicaid) (PSGor Medicaid) island-wide. The Company also offers complementary products and services, including life insurance, accident and disability insurance and property and casualty insurance. The Company has right to use the Blue Cross and Blue Shield (BCBS) name and mark throughout Puerto Rico, the United States Virgin Islands, Costa Rica, the British Virgin Islands and Anguilla. Its subsidiaries include Triple-S Salud, Inc. (TSS) and Triple-S Advantage, Inc. (TSA).

Managed Care

Through its subsidiaries TSS and TSA, the Company offers a range of managed care products, including Health Maintenance Organization (HMO) plans, Preferred Provider Organization (PPO) plans, Medicare Supplement, Medicare Advantage and Medicaid plans. Managed care products represented approximately 89% of its revenue for the year ended December 31, 2014. 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 include emergency care, inpatient hospital and physician care, outpatient medical services and supplemental services, such as dental, vision, behavioral and prescription drugs, among others. 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. In addition, the Company provides its PPO members with access to a network of providers than its HMO. In contrast to its HMO product, the Company does not require its PPO members to select a primary care physician or to obtain a referral to utilize in-network specialists. The Company also provides coverage for PPO members who access providers outside of the network. The Company also offers national in-network coverage to its PPO members through the BlueCard program.

For its members who purchase its PPO and selected members under ASO arrangements through its subsidiary TSS, the Company offers the BlueCard program. The BlueCard program offers these members in-network benefits through the networks of the other BCBS plans in the United States. In addition, the BlueCard worldwide program provides its PPO members with coverage for medical assistance across the world. The Company 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 on a stand-alone basis. The Company 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, 2014, the Company had enrolled approximately 7,197 members in the Drug Discount Card program. In addition to its fully insured plans, the Company also offers its PPO products on a self-funded or ASO basis, under which the Company provides claims processing and other administrative services to employers and Medicaid. For certain self-funded plans, the Company provides stop loss insurance pursuant to which the Company assumes some of the medical risk for a premium.

Life Insurance

The Company offers a variety of life, accident, disability and health and annuity products in Puerto Rico through its subsidiary TSV. Life insurance premiums represented approximately 7% of its consolidated revenue for the year ended December 31, 2014. 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. The Company offers guaranteed issue, funeral and cancer policies to the lower and middle income market segments directly to people in their homes. The Company also markets its group life and disability coverage through its independent producers.

Property and Casualty Insurance

The Company offers a range of property and casualty insurance products through its subsidiary Triple-S Propiedad, Inc. (TSP). Property and casualty insurance premiums represented approximately 4% of its revenues for the year ended December 31, 2014. Its insurance products are commercial multi-peril package, personal package, commercial auto, hospital malpractice, commercial liability and commercial property. This segment's commercial products focus on small to medium size accounts.

The Company competes with Medical Card Systems Inc., InnovaCare, Inc., Humana, Inc., First Medical Health Plan, Inc., Mass Mutual Financial Group, Cooperativa de Seguros de Vida de Puerto Rico, AXA Equitable Life, AFLAC, Trans Oceanic Life Insurance Company, American International Insurance Company, Universal Insurance and MAPFRE Corporation Group.

Company Address

Triple-S Management Corp

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

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