Profile: Triple-S Management Corp (GTS)
4 May 2015
Triple-S Management Corporation (TSM), incorporated on October 9, 1996, is a holding company. The Company through its subsidiaries, Triple-S Salud, Inc. and American Health, offers the products in the managed care segment to three distinct market sectors: Commercial, Medicare and Medicaid. The Company offers products and services, including life insurance, accident and disability insurance and property and casualty insurance. The Company distributes and markets the products through channels, including salaried and commission-based internal sales force, direct mail, independent brokers and agents, telemarketing staff, and the Internet. The Company brands its products under the name Triple-S and the BCBS mark. The Company’s life insurance segment, offers the insurance products through network of both company-employed and independent agents. The Company’s life insurance customers consist primarily of individuals, who hold approximately 525,000 policies.
The Company has developed and implemented integrated information technology systems that collect and process information centrally and support the administrative functions, including billing, claims processing, utilization management, reporting, medical cost trending, as well as certain member and provider service functions, including enrollment, member eligibility verification, claims status inquiries, and referrals and authorizations. The Company provides individual and family contracts.
The commercial accounts include corporate accounts, federal government employees, individual accounts, local government employees, and Medicare Supplement. The Company provides services to Federal Government Employees under the Federal Employees Health Benefits Program and managed care services to individuals and their dependent family members. The Company offers Medicare Supplement products, which provide supplemental coverage, such as deductibles, coinsurance and specified losses. Medicare also provides a prescription drug program. The Company’s Medicare Advantage policies offer Medicare Part D coverage to the members throughout the service area. The Company also offers a stand-alone Medicare Part D prescription drug benefits product.
Managed Care segment offers managed care products, including Health Maintenance Organizations (HMO) plans, Preferred Provider Organizations plans (PPO), Medicare Supplement, Medicare Advantage, Medicare Part D and Medicaid plans. The Company serves customers, including employers, professional and trade associations, individuals and government entities. The Company provides network access, medical cost management, claim processing, stop-loss insurance and other administrative services. 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 members and their dependent family members with health care coverage in exchange for a fixed monthly premium. The Company provides coverage for PPO members who access providers outside of the network and also offers national in-network coverage to PPO members through the BlueCard program. The BlueCard program offers these members in-network benefits through the networks of the other BCBS plans in the United States and certain U.S. territories and also provides PPO members with coverage for medical assistance worldwide. The Company offers PPO products provide claims processing and other administrative services to employers and Medicaid. For certain self-funded plans, the Company provide stop loss insurance.
The Company competes with Medical Card Systems Inc., InnovaCare, Inc., Humana, Inc. and First Medical Health Plan, Inc.
The Company offers life, accident, disability and health and annuity products. The Company markets in-home service life and supplemental health products through a network of company-employed agents. Ordinary life, cancer and dreaded diseases, 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 markets group life and disability coverage through 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 property and casualty insurance products. The Company’s predominant lines of business are commercial multi-peril, commercial property mono-line, auto physical damage, auto liability and dwelling policies. The Company’s commercial lines target small to medium size accounts. During the year ended December 31, 2013, 37.9% of the premiums written in the property and casualty insurance segment were ceded to reinsurers.
The Company competes with Universal Insurance, MAPFRE Corporation Group, and Cooperativa de Seguros Multiples de Puerto Rico.
Triple-S Management Corp
1441 F.D. Roosevelt Ave.,
P.O. Box 363628
SAN JUAN 00936