(State or other jurisdiction of incorporation or organization) |
(I.R.S. Employer Identification No.) |
(Address of principal executive offices) |
(Zip code) |
( |
(Registrant’s telephone number, including area code) |
Not applicable |
(Former name, former address and former fiscal year, if changed since last report) |
Title of each class |
Trading Symbol(s) |
Name of each exchange on which registered |
Accelerated filer ☐ |
|
Non-accelerated filer ☐ |
Smaller reporting company |
Emerging growth company |
Title of each class |
Outstanding at September 30, 2020 |
Common Stock Class B, $1.00 par value |
3 |
|
34 |
|
34 |
|
34 |
|
35 |
|
38 |
|
38 |
|
39 |
|
41 |
|
44 |
|
45 |
|
46 |
|
48 |
|
48 |
|
49 |
|
49 |
|
49 |
|
51 |
|
51 |
|
51 |
|
51 |
|
52 |
|
53 |
September 30, 2020 |
December 31, 2019 |
|||||||
Assets |
||||||||
Investments and cash: |
||||||||
Fixed maturities available for sale, at fair value |
$ |
$ |
||||||
Fixed maturities held to maturity, at amortized cost |
||||||||
Equity investments, at fair value |
||||||||
Other invested assets, at net asset value |
||||||||
Policy loans |
||||||||
Cash and cash equivalents |
||||||||
Total investments and cash |
||||||||
Premiums and other receivables, net |
||||||||
Deferred policy acquisition costs and value of business acquired |
||||||||
Property and equipment, net |
||||||||
Deferred tax asset |
||||||||
Goodwill |
||||||||
Other assets |
||||||||
Total assets |
$ |
$ |
||||||
Liabilities and Stockholders' Equity |
||||||||
Claim liabilities |
$ |
$ |
||||||
Liability for future policy benefits |
||||||||
Unearned premiums |
||||||||
Policyholder deposits |
||||||||
Liability to Federal Employees' Health Benefits and Federal Employees' Programs |
||||||||
Accounts payable and accrued liabilities |
||||||||
Deferred tax liability |
||||||||
Short-term borrowings |
||||||||
Long-term borrowings |
||||||||
Liability for pension benefits |
||||||||
Total liabilities |
||||||||
Stockholders’ equity: |
||||||||
Triple-S Management Corporation stockholders' equity |
||||||||
Common stock Class B, $ |
||||||||
Additional paid-in capital |
||||||||
Retained earnings |
||||||||
Accumulated other comprehensive income |
||||||||
Total Triple-S Management Corporation stockholders' equity |
||||||||
Non-controlling interest in consolidated subsidiary |
( |
) |
( |
) |
||||
Total stockholders' equity |
||||||||
Total liabilities and stockholders' equity |
$ |
$ |
Three months ended September 30, |
Nine months ended September 30, |
|||||||||||||||
2020 |
2019 |
2020 |
2019 |
|||||||||||||
Revenues: |
||||||||||||||||
Premiums earned, net |
$ |
$ |
$ |
$ |
||||||||||||
Administrative service fees |
||||||||||||||||
Net investment income |
||||||||||||||||
Other operating revenues |
||||||||||||||||
Total operating revenues |
||||||||||||||||
Net realized investment gains (losses) |
( |
) |
||||||||||||||
Net unrealized investment gains (losses) on equity investments |
( |
) |
||||||||||||||
Other income, net |
||||||||||||||||
Total revenues |
||||||||||||||||
Benefits and expenses: |
||||||||||||||||
Claims incurred |
||||||||||||||||
Operating expenses |
||||||||||||||||
Total operating costs |
||||||||||||||||
Interest expense |
||||||||||||||||
Total benefits and expenses |
||||||||||||||||
Income before taxes |
||||||||||||||||
Income tax expense |
||||||||||||||||
Net income |
||||||||||||||||
Net loss attributable to non-controlling interest |
( |
) |
( |
) |
( |
) |
( |
) |
||||||||
Net income attributable to Triple-S Management Corporation |
$ |
$ |
$ |
$ |
||||||||||||
Earnings per share attributable to Triple-S Management Corporation |
||||||||||||||||
Basic net income per share |
$ |
$ |
$ |
$ |
||||||||||||
Diluted net income per share |
$ |
$ |
$ |
$ |
Three months ended September 30, |
Nine months ended September 30, |
|||||||||||||||
2020 |
2019 |
2020 |
2019 |
|||||||||||||
Net income |
$ |
$ |
$ |
$ |
||||||||||||
Other comprehensive income, net of tax: |
||||||||||||||||
Net unrealized change in fair value of available for sale securities, net of taxes |
||||||||||||||||
Defined benefit pension plan: |
||||||||||||||||
Actuarial loss, net |
||||||||||||||||
Total other comprehensive income, net of tax |
||||||||||||||||
Comprehensive income |
||||||||||||||||
Comprehensive loss attributable to non-controlling interest |
( |
) |
( |
) |
( |
) |
( |
) |
||||||||
Comprehensive income attributable to Triple-S Management Corporation |
$ |
$ |
$ |
$ |
Class A Common Stock |
Class B Common Stock |
Additional Paid-in Capital |
Retained Earnings |
Accumulated Other Comprehensive Income |
Triple-S Management Corporation Stockholders’ Equity |
Non-controlling Interest in Consolidated Subsidiary |
Total Stockholders’ Equity |
|||||||||||||||||||||||||
Balance, December 31, 2019 |
$ |
$ |
$ |
$ |
$ |
$ |
$ |
( |
) |
$ |
||||||||||||||||||||||
Share-based compensation |
||||||||||||||||||||||||||||||||
Repurchase and retirement of common stock |
( |
) |
( |
) |
( |
) |
( |
) |
||||||||||||||||||||||||
Comprehensive (loss) income |
( |
) |
( |
) |
( |
) |
( |
) |
||||||||||||||||||||||||
Cummulative effect adjustment due to implementation of ASU 2016-13 |
( |
) |
( |
) |
( |
) |
||||||||||||||||||||||||||
Balance, March 31, 2020 |
$ |
$ |
$ |
$ |
$ |
$ |
$ |
( |
) |
$ |
||||||||||||||||||||||
Share-based compensation |
||||||||||||||||||||||||||||||||
Repurchase and retirement of common stock |
( |
) |
( |
) |
( |
) |
( |
) |
||||||||||||||||||||||||
Comprehensive income (loss) |
( |
) |
||||||||||||||||||||||||||||||
Balance, June 30, 2020 |
$ |
$ |
$ |
$ |
$ |
$ |
$ |
( |
) |
$ |
||||||||||||||||||||||
Share-based compensation |
||||||||||||||||||||||||||||||||
Repurchase and retirement of common stock |
( |
) |
( |
) |
( |
) |
( |
) |
||||||||||||||||||||||||
Comprehensive income (loss) |
( |
) |
||||||||||||||||||||||||||||||
Balance, September 30, 2020 |
$ |
$ |
$ |
$ |
$ |
$ |
$ |
( |
) |
$ |
||||||||||||||||||||||
Balance, December 31, 2018 |
$ |
$ |
$ |
$ |
$ |
$ |
$ |
( |
) |
$ |
||||||||||||||||||||||
Share-based compensation |
||||||||||||||||||||||||||||||||
Repurchase and retirement of common stock |
( |
) |
( |
) |
( |
) |
( |
) |
||||||||||||||||||||||||
Comprehensive income (loss) |
( |
) |
||||||||||||||||||||||||||||||
Balance, March 31, 2019 |
$ |
$ |
$ |
$ |
$ |
$ |
$ |
( |
) |
$ |
||||||||||||||||||||||
Share-based compensation |
||||||||||||||||||||||||||||||||
Comprehensive income (loss) |
( |
) |
||||||||||||||||||||||||||||||
Balance, June 30, 2019 |
$ |
$ |
$ |
$ |
$ |
$ |
$ |
( |
) |
$ |
||||||||||||||||||||||
Share-based compensation |
||||||||||||||||||||||||||||||||
Issuance of Common Stock |
||||||||||||||||||||||||||||||||
Stock dividend |
( |
) |
||||||||||||||||||||||||||||||
Dividend |
( |
) |
( |
) |
( |
) |
||||||||||||||||||||||||||
Common Stock Class A conversion to Class B |
( |
) |
||||||||||||||||||||||||||||||
Comprehensive income (loss) |
( |
) |
||||||||||||||||||||||||||||||
Balance, September 30, 2019 |
$ |
$ |
$ |
$ |
$ |
$ |
$ |
( |
) |
$ |
Nine months ended September 30, |
||||||||
2020 |
2019 |
|||||||
Cash flows from operating activities: |
||||||||
Net income |
$ |
$ |
||||||
Adjustments to reconcile net income to net cash provided by operating activities: |
||||||||
Depreciation and amortization |
||||||||
Net amortization of investments |
||||||||
Provision for doubtful receivables |
||||||||
Deferred tax expense |
||||||||
Net realized investment losses (gains) on sale of securities |
( |
) |
||||||
Net unrealized losses (gains) on equity investments |
( |
) |
||||||
Interest credited to policyholder deposits |
||||||||
Share-based compensation |
||||||||
Gain on sale of property and equipment |
||||||||
Decrease (increase) in assets: |
||||||||
Premium and other receivables, net |
||||||||
Deferred policy acquisition costs and value of business acquired |
( |
) |
( |
) |
||||
Deferred taxes |
( |
) |
||||||
Other assets |
( |
) |
( |
) |
||||
Increase (decrease) in liabilities: |
||||||||
Claim liabilities |
( |
) |
||||||
Liability for future policy benefits |
||||||||
Unearned premiums |
||||||||
Liability to Federal Employees' Health Benefits and Federal Employees' Programs |
||||||||
Accounts payable and accrued liabilities |
||||||||
Net cash provided by (used in) operating activities |
( |
) |
Nine months ended September 30, |
||||||||
2020 |
2019 |
|||||||
Cash flows from investing activities: |
||||||||
Proceeds from investments sold or matured: |
||||||||
Securities available for sale: |
||||||||
Fixed maturities sold |
$ |
$ |
||||||
Fixed maturities matured/called |
||||||||
Securities held to maturity: |
||||||||
Fixed maturities matured/called |
||||||||
Equity investments sold |
||||||||
Other invested assets sold |
||||||||
Acquisition of investments: |
||||||||
Securities available for sale: |
||||||||
Fixed maturities |
( |
) |
( |
) |
||||
Securities held to maturity: |
||||||||
Fixed maturities |
( |
) |
( |
) |
||||
Equity investments |
( |
) |
( |
) |
||||
Other invested assets |
( |
) |
( |
) |
||||
Increase in other investments |
( |
) |
( |
) |
||||
Net change in policy loans |
( |
) |
||||||
Net capital expenditures |
( |
) |
( |
) |
||||
Capital contribution on equity method investees |
( |
) |
||||||
Net cash used in investing activities |
( |
) |
( |
) |
||||
Cash flows from financing activities: |
||||||||
Change in outstanding checks in excess of bank balances |
||||||||
Net change in short-term borrowings |
||||||||
Proceeds from long-term borrowings |
||||||||
Repayments of long-term borrowings |
( |
) |
( |
) |
||||
Repurchase and retirement of common stock |
( |
) |
( |
) |
||||
Proceeds from policyholder deposits |
||||||||
Surrenders of policyholder deposits |
( |
) |
( |
) |
||||
Net cash provided by (used in) financing activities |
( |
) |
||||||
Net increase (decrease) in cash and cash equivalents |
( |
) |
||||||
Cash and cash equivalents: |
||||||||
Beginning of period |
||||||||
End of period |
$ |
$ |
Triple-S Management Corporation Notes to Condensed Consolidated Interim Financial Statements (dollar amounts in thousands, except per share data) (Unaudited) |
(1) | Basis of Presentation |
(2) | Significant Accounting Policies |
Triple-S Management Corporation Notes to Condensed Consolidated Interim Financial Statements (dollar amounts in thousands, except per share data) (Unaudited) |
Triple-S Management Corporation Notes to Condensed Consolidated Interim Financial Statements (dollar amounts in thousands, except per share data) (Unaudited) |
Triple-S Management Corporation Notes to Condensed Consolidated Interim Financial Statements (dollar amounts in thousands, except per share data) (Unaudited) |
Triple-S Management Corporation Notes to Condensed Consolidated Interim Financial Statements (dollar amounts in thousands, except per share data) (Unaudited) |
(3) | Investment in Securities |
September 30, 2020 |
||||||||||||||||
Amortized cost |
Gross unrealized gains |
Gross unrealized losses |
Estimated fair value |
|||||||||||||
Fixed maturities available for sale |
||||||||||||||||
Obligations of government- sponsored enterprises |
$ |
$ |
$ |
( |
) |
$ |
||||||||||
U.S. Treasury securities and obligations of U.S. government instrumentalities |
||||||||||||||||
Municipal securities |
( |
) |
||||||||||||||
Corporate bonds |
||||||||||||||||
Residential mortgage-backed securities |
( |
) |
||||||||||||||
Collateralized mortgage obligations |
( |
) |
||||||||||||||
Total fixed maturities available for sale |
$ |
$ |
$ |
( |
) |
$ |
December 31, 2019 |
||||||||||||||||
Amortized Cost |
Gross Unrealized Gains |
Gross Unrealized Losses |
Estimated Fair Value |
|||||||||||||
Fixed maturities available for sale |
||||||||||||||||
Obligations of government- sponsored enterprises |
$ |
$ |
$ |
$ |
||||||||||||
U.S. Treasury securities and obligations of U.S. government instrumentalities |
||||||||||||||||
Municipal securities |
( |
) |
||||||||||||||
Corporate bonds |
( |
) |
||||||||||||||
Residential mortgage-backed securities |
( |
) |
||||||||||||||
Collateralized mortgage obligations |
||||||||||||||||
Total fixed maturities available for sale |
$ |
$ |
$ |
( |
) |
$ |
Triple-S Management Corporation Notes to Condensed Consolidated Interim Financial Statements (dollar amounts in thousands, except per share data) (Unaudited) |
September 30, 2020 |
||||||||||||||||
Amortized cost |
Gross unrealized gains |
Gross unrealized losses |
Estimated fair value |
|||||||||||||
Fixed maturities held to maturity |
||||||||||||||||
U.S. Treasury securities and obligations of U.S. government instrumentalities |
$ |
$ |
$ |
$ |
||||||||||||
Residential mortgage-backed securities |
||||||||||||||||
Certificates of deposit |
||||||||||||||||
Total |
$ |
$ |
$ |
$ |
December 31, 2019 |
||||||||||||||||
Amortized cost |
Gross unrealized gains |
Gross unrealized losses |
Estimated fair value |
|||||||||||||
Securities held to maturity |
||||||||||||||||
U.S. Treasury securities and obligations of U.S. government instrumentalities |
$ |
$ |
$ |
$ |
||||||||||||
Residential mortgage-backed securities |
||||||||||||||||
Certificates of deposit |
||||||||||||||||
Total |
$ |
$ |
$ |
$ |
September 30, 2020 |
||||||||||||||||
Amortized cost |
Gross unrealized gains |
Gross unrealized losses |
Estimated fair value |
|||||||||||||
Other invested assets - Alternative investments |
$ |
$ |
$ |
( |
) |
$ |
December 31, 2019 |
||||||||||||||||
Amortized cost |
Gross unrealized gains |
Gross unrealized losses |
Estimated fair value |
|||||||||||||
Other invested assets - Alternative investments |
$ |
$ |
$ |
( |
) |
$ |
Triple-S Management Corporation Notes to Condensed Consolidated Interim Financial Statements (dollar amounts in thousands, except per share data) (Unaudited) |
September 30, 2020 |
||||||||||||||||||||||||||||||||||||
Less than 12 months |
12 months or longer |
Total |
||||||||||||||||||||||||||||||||||
Estimated Fair Value |
Gross Unrealized Loss |
Number of Securities |
Estimated Fair Value |
Gross Unrealized Loss |
Number of Securities |
Estimated Fair Value |
Gross Unrealized Loss |
Number of Securities |
||||||||||||||||||||||||||||
Fixed maturities available for sale |
||||||||||||||||||||||||||||||||||||
Obligations of government-sponsored enterprises |
$ |
$ |
( |
) |
$ |
$ |
$ |
$ |
( |
) |
||||||||||||||||||||||||||
Municipal securities |
( |
) |
( |
) |
||||||||||||||||||||||||||||||||
Residential mortgage-backed securities |
( |
) |
( |
) |
||||||||||||||||||||||||||||||||
Collateralized mortgage obligations |
( |
) |
( |
) |
||||||||||||||||||||||||||||||||
Total fixed maturities |
$ |
$ |
( |
) |
$ |
$ |
$ |
$ |
( |
) |
||||||||||||||||||||||||||
Other invested assets - Alternative investments |
$ |
$ |
( |
) |
$ |
$ |
( |
) |
$ |
$ |
( |
) |
December 31, 2019 |
||||||||||||||||||||||||||||||||||||
Less than 12 months |
12 months or longer |
Total |
||||||||||||||||||||||||||||||||||
Estimated Fair Value |
Gross Unrealized Loss |
Number of Securities |
Estimated Fair Value |
Gross Unrealized Loss |
Number of Securities |
Estimated Fair Value |
Gross Unrealized Loss |
Number of Securities |
||||||||||||||||||||||||||||
Fixed maturities available for sale |
||||||||||||||||||||||||||||||||||||
Municipal securities |
$ |
$ |
( |
) |
$ |
$ |
$ |
$ |
( |
) |
||||||||||||||||||||||||||
Corporate bonds |
( |
) |
( |
) |
||||||||||||||||||||||||||||||||
Residential mortgage-backed securities |
( |
) |
( |
) |
||||||||||||||||||||||||||||||||
Total fixed maturities |
$ |
$ |
( |
) |
$ |
$ |
$ |
$ |
( |
) |
||||||||||||||||||||||||||
Other invested assets - Alternative investments |
$ |
$ |
( |
) |
$ |
$ |
( |
) |
$ |
$ |
( |
) |
Triple-S Management Corporation Notes to Condensed Consolidated Interim Financial Statements (dollar amounts in thousands, except per share data) (Unaudited) |
September 30, 2020 |
||||||||
Amortized cost |
Estimated fair value |
|||||||
Fixed maturities available for sale |
||||||||
Due in one year or less |
$ |
$ |
||||||
Due after one year through five years |
||||||||
Due after five years through ten years |
||||||||
Due after ten years |
||||||||
Residential mortgage-backed securities |
||||||||
Collateralized mortgage obligations |
||||||||
$ |
$ |
|||||||
Fixed maturities held to maturity |
||||||||
Due in one year or less |
$ |
$ |
||||||
Due after ten years |
||||||||
Residential mortgage-backed securities |
||||||||
$ |
$ |
Triple-S Management Corporation Notes to Condensed Consolidated Interim Financial Statements (dollar amounts in thousands, except per share data) (Unaudited) |
(4) | Realized and Unrealized Gains (Losses) |
Three months ended September 30, |
Nine months ended September 30, |
|||||||||||||||
2020 |
2019 |
2020 |
2019 |
|||||||||||||
Realized gains (losses) |
||||||||||||||||
Fixed maturity securities: |
||||||||||||||||
Securities available for sale: |
||||||||||||||||
Gross gains |
$ |
$ |
$ |
$ |
||||||||||||
Gross losses |
( |
) |
( |
) |
( |
) |
||||||||||
Total fixed securities |
||||||||||||||||
Equity investments: |
||||||||||||||||
Gross gains |
||||||||||||||||
Gross losses |
( |
) |
( |
) |
( |
) |
( |
) |
||||||||
Gross losses from impaired securities |
( |
) |
||||||||||||||
Total equity investments |
( |
) |
( |
) |
( |
) |
||||||||||
Other invested assets: |
||||||||||||||||
Gross gains |
||||||||||||||||
Gross losses |
( |
) |
||||||||||||||
Total other invested assets |
||||||||||||||||
Net realized investment gains (losses) |
$ |
$ |
$ |
( |
) |
$ |
Three months ended September 30, |
Nine months ended September 30, |
|||||||||||||||
2020 |
2019 |
2020 |
2019 |
|||||||||||||
Changes in net unrealized gains (losses): |
||||||||||||||||
Recognized in accumulated other comprehensive income (loss): |
||||||||||||||||
Fixed maturities – available for sale |
$ |
$ |
$ |
$ |
||||||||||||
Other invested assets |
( |
) |
||||||||||||||
$ |
$ |
$ |
$ |
|||||||||||||
Not recognized in the consolidated financial statements: |
||||||||||||||||
Fixed maturities – held to maturity |
$ |
( |
) |
$ |
$ |
$ |
Triple-S Management Corporation Notes to Condensed Consolidated Interim Financial Statements (dollar amounts in thousands, except per share data) (Unaudited) |
(5) | Premiums and Other Receivables, Net |
September 30, 2020 |
December 31, 2019 |
|||||||
Premium |
$ |
$ |
||||||
Self-funded group receivables |
||||||||
FEHBP |
||||||||
Agent balances |
||||||||
Accrued interest |
||||||||
Reinsurance recoverable |
||||||||
Other |
||||||||
Less allowance for doubtful receivables: |
||||||||
Premium |
||||||||
Other |
||||||||
Total premium and other receivables, net |
$ |
$ |
(6) | Property and Equipment, Net |
September 30, |
December 31, |
|||||||
2020 |
2019 |
|||||||
Land |
$ |
$ |
||||||
Buildings and leasehold improvements |
||||||||
Office furniture and equipment |
||||||||
Computer equipment and software |
||||||||
Automobiles |
||||||||
Less accumulated depreciation and amortization |
||||||||
Property and equipment, net |
$ |
$ |
Triple-S Management Corporation Notes to Condensed Consolidated Interim Financial Statements (dollar amounts in thousands, except per share data) (Unaudited) |
(7) | Fair Value Measurements |
September 30, 2020 |
||||||||||||||||
Level 1 |
Level 2 |
Level 3 |
Total |
|||||||||||||
Fixed maturity securities available for sale |
||||||||||||||||
Obligations of government-sponsored enterprises |
$ |
$ |
$ |
$ |
||||||||||||
U.S. Treasury securities and obligations of U.S government instrumentalities |
||||||||||||||||
Municipal securities |
||||||||||||||||
Corporate bonds |
||||||||||||||||
Residential agency mortgage-backed securities |
||||||||||||||||
Collateralized mortgage obligations |
||||||||||||||||
Total fixed maturities |
$ |
$ |
$ |
$ |
||||||||||||
Equity investments |
$ |
$ |
$ |
$ |
December 31, 2019 |
||||||||||||||||
Level 1 |
Level 2 |
Level 3 |
Total |
|||||||||||||
Fixed maturity securities available for sale |
||||||||||||||||
Obligations of government-sponsored enterprises |
$ |
$ |
$ |
$ |
||||||||||||
U.S. Treasury securities and obligations of U.S government instrumentalities |
||||||||||||||||
Municipal securities |
||||||||||||||||
Corporate bonds |
||||||||||||||||
Residential agency mortgage-backed securities |
||||||||||||||||
Collateralized mortgage obligations |
||||||||||||||||
Total fixed maturities |
$ |
$ |
$ |
$ |
||||||||||||
Equity investments |
$ |
$ |
$ |
$ |
Triple-S Management Corporation Notes to Condensed Consolidated Interim Financial Statements (dollar amounts in thousands, except per share data) (Unaudited) |
Fair Value Measurements Using Significant Unobservable Inputs (Level 3) |
||||||||
Three months ended |
Nine months ended |
|||||||
September 30, 2020 |
September 30, 2020 |
|||||||
Beginning Balance |
$ |
$ |
||||||
Unrealized in other accumulated comprehensive income |
( |
) |
( |
) |
||||
Ending Balance |
$ |
$ |
(8) | Claim Liabilities |
Nine months ended September 30, 2020 |
||||||||||||
Managed Care |
Other Business Segments * |
Consolidated |
||||||||||
Claim liabilities at beginning of period |
$ |
$ |
$ |
|||||||||
Reinsurance recoverable on claim liabilities |
( |
) |
( |
) |
||||||||
Net claim liabilities at beginning of period |
||||||||||||
Claims incurred |
||||||||||||
Current period insured events |
||||||||||||
Prior period insured events |
( |
) |
||||||||||
Total |
||||||||||||
Payments of losses and loss-adjustment expenses |
||||||||||||
Current period insured events |
||||||||||||
Prior period insured events |
||||||||||||
Total |
||||||||||||
Net claim liabilities at end of period |
||||||||||||
Reinsurance recoverable on claim liabilities |
||||||||||||
Claim liabilities at end of period |
$ |
$ |
$ |
Triple-S Management Corporation Notes to Condensed Consolidated Interim Financial Statements (dollar amounts in thousands, except per share data) (Unaudited) |
Nine months ended September 30, 2019 |
||||||||||||
Managed Care |
Other Business Segments * |
Consolidated |
||||||||||
Claim liabilities at beginning of period |
$ |
$ |
$ |
|||||||||
Reinsurance recoverable on claim liabilities |
( |
) |
( |
) |
||||||||
Net claim liabilities at beginning of period |
||||||||||||
Claims incurred |
||||||||||||
Current period insured events |
||||||||||||
Prior period insured events |
( |
) |
( |
) |
( |
) |
||||||
Total |
||||||||||||
Payments of losses and loss-adjustment expenses |
||||||||||||
Current period insured events |
||||||||||||
Prior period insured events |
||||||||||||
Total |
||||||||||||
Net claim liabilities at end of period |
||||||||||||
Reinsurance recoverable on claim liabilities |
||||||||||||
Claim liabilities at end of period |
$ |
$ |
$ |
Triple-S Management Corporation Notes to Condensed Consolidated Interim Financial Statements (dollar amounts in thousands, except per share data) (Unaudited) |
Incurred Year |
Total of IBNR Liabilities Plus Expected Development on Reported Claims |
|||
2019 |
$ |
|||
2020 |
(9) | Borrowings |
September 30, 2020 |
December 31, 2019 |
|||||||
Secured loan payable of $ |
$ |
$ |
||||||
Secured loan payable of $ |
||||||||
Secured loan payable of $ |
||||||||
Secured loan payable of $ |
||||||||
Total borrowings |
||||||||
Less: unamortized debt issuance costs |
||||||||
$ |
$ |
Triple-S Management Corporation Notes to Condensed Consolidated Interim Financial Statements (dollar amounts in thousands, except per share data) (Unaudited) |
Remaining of 2020 |
$ |
|||
2021 |
||||
2022 |
||||
2023 |
||||
2024 |
||||
Thereafter |
||||
$ |
• | In August 2019, Triple-S Salud, Inc. (TSS) and Triple-S Vida, Inc. (TSV) became members of the FHLBNY, which provides access to collateralized advances. The borrowing capacity of TSS and TSV is up to |
• | Triple-S Advantage, Inc. (TSA) has a $ |
Triple-S Management Corporation Notes to Condensed Consolidated Interim Financial Statements (dollar amounts in thousands, except per share data) (Unaudited) |
(10) | Pension Plan |
Three months ended September 30, |
Nine months ended September 30, |
|||||||||||||||
2020 |
2019 |
2020 |
2019 |
|||||||||||||
Components of net periodic benefit cost (income): |
||||||||||||||||
Interest cost |
$ |
$ |
$ |
$ |
||||||||||||
Expected return on assets |
( |
) |
( |
) |
( |
) |
( |
) |
||||||||
Amortization of actuarial loss |
||||||||||||||||
Settlement loss |
||||||||||||||||
Net periodic benefit cost (income) |
$ |
$ |
$ |
( |
) |
$ |
(11) | Stock Repurchase Program |
(12) | Reinsurance |
Triple-S Management Corporation Notes to Condensed Consolidated Interim Financial Statements (dollar amounts in thousands, except per share data) (Unaudited) |
• |
Casualty excess of loss treaty provides reinsurance for losses up to $ |
• |
Medical malpractice excess of loss treaty provides reinsurance for losses up to $ |
• |
Property reinsurance treaty includes proportional cessions and a per risk excess of loss contract limiting losses to $ |
• |
Catastrophe protection is purchased limiting losses to $ |
(13) | Leases |
Triple-S Management Corporation Notes to Condensed Consolidated Interim Financial Statements (dollar amounts in thousands, except per share data) (Unaudited) |
Remaning of 2020 |
$ |
|||
2021 |
||||
2022 |
||||
2023 |
||||
2024 |
||||
Thereafter |
||||
Total lease payments |
||||
Less: imputed interest |
( |
) |
||
Total |
$ |
Nine months ended |
||||
September 30, 2020 |
||||
Operating lease cost |
$ |
|||
Short-term lease cost |
||||
Total lease cost |
$ |
Remaining of 2020 |
$ |
|||
2021 |
||||
2022 |
||||
2023 |
||||
2024 |
||||
Thereafter |
||||
Total |
$ |
Triple-S Management Corporation Notes to Condensed Consolidated Interim Financial Statements (dollar amounts in thousands, except per share data) (Unaudited) |
(14) | Comprehensive Income (Loss) |
Three months ended |
Nine months ended |
|||||||||||||||
September 30, |
September 30, |
|||||||||||||||
2020 |
2019 |
2020 |
2019 |
|||||||||||||
Net Unrealized Gain on Securities |
||||||||||||||||
Beginning Balance |
$ |
$ |
$ |
$ |
||||||||||||
Other comprehensive income before reclassifications |
||||||||||||||||
Amounts reclassified from accumulated other comprehensive (loss) income |
( |
) |
( |
) |
( |
) |
||||||||||
Net current period change |
||||||||||||||||
Ending Balance |
||||||||||||||||
Liability for Pension Benefits |
||||||||||||||||
Beginning Balance |
( |
) |
( |
) |
( |
) |
( |
) |
||||||||
Amounts reclassified from accumulated other comprehensive income |
||||||||||||||||
Ending Balance |
( |
) |
( |
) |
( |
) |
( |
) |
||||||||
Accumulated Other Comprehensive Income (Loss) |
||||||||||||||||
Beginning Balance |
||||||||||||||||
Other comprehensive income before reclassifications |
||||||||||||||||
Amounts reclassified from accumulated other comprehensive (loss) income |
( |
) |
( |
) |
( |
) |
||||||||||
Net current period change |
||||||||||||||||
Ending Balance |
$ |
$ |
$ |
$ |
(15) | Share-Based Compensation |
(16) | Net Income Available to Stockholders and Net Income per Share |
Three months ended September 30, |
Nine months ended September 30, |
|||||||||||||||
2020 |
2019 |
2020 |
2019 |
|||||||||||||
Numerator for earnings per share: |
||||||||||||||||
Net income attributable to TSM available to stockholders |
$ |
$ |
$ |
$ |
||||||||||||
Denominator for basic earnings per share: |
||||||||||||||||
Weighted average of common shares |
||||||||||||||||
Effect of dilutive securities |
||||||||||||||||
Denominator for diluted earnings per share |
||||||||||||||||
Basic net income per share attributable to TSM |
$ |
$ |
$ |
$ |
||||||||||||
Diluted net income per share attributable to TSM |
$ |
$ |
$ |
$ |
Triple-S Management Corporation Notes to Condensed Consolidated Interim Financial Statements (dollar amounts in thousands, except per share data) (Unaudited) |
Triple-S Management Corporation Notes to Condensed Consolidated Interim Financial Statements (dollar amounts in thousands, except per share data) (Unaudited) |
Triple-S Management Corporation Notes to Condensed Consolidated Interim Financial Statements (dollar amounts in thousands, except per share data) (Unaudited) |
(18) | Segment Information |
Triple-S Management Corporation Notes to Condensed Consolidated Interim Financial Statements (dollar amounts in thousands, except per share data) (Unaudited) |
Three months ended September 30, |
Nine months ended September 30, |
|||||||||||||||
2020 |
2019 |
2020 |
2019 |
|||||||||||||
Operating revenues: |
||||||||||||||||
Managed Care: |
||||||||||||||||
Premiums earned, net |
$ |
$ |
$ |
$ |
||||||||||||
Administrative service fees |
||||||||||||||||
Intersegment premiums/service fees |
||||||||||||||||
Net investment income |
||||||||||||||||
Total managed care |
||||||||||||||||
Life Insurance: |
||||||||||||||||
Premiums earned, net |
||||||||||||||||
Intersegment premiums |
||||||||||||||||
Net investment income |
||||||||||||||||
Total life insurance |
||||||||||||||||
Property and Casualty Insurance: |
||||||||||||||||
Premiums earned, net |
||||||||||||||||
Intersegment premiums |
||||||||||||||||
Net investment income |
||||||||||||||||
Total property and casualty insurance |
||||||||||||||||
Other segments: * |
||||||||||||||||
Intersegment service revenues |
||||||||||||||||
Operating revenues from external sources |
||||||||||||||||
Total other segments |
||||||||||||||||
Total business segments |
||||||||||||||||
TSM operating revenues from external sources |
||||||||||||||||
Elimination of intersegment premiums/service fees |
( |
) |
( |
) |
( |
) |
( |
) |
||||||||
Elimination of intersegment service revenues |
( |
) |
( |
) |
( |
) |
( |
) |
||||||||
Consolidated operating revenues |
$ |
$ |
$ |
$ |
Triple-S Management Corporation Notes to Condensed Consolidated Interim Financial Statements (dollar amounts in thousands, except per share data) (Unaudited) |
Three months ended September 30, |
Nine months ended September 30, |
|||||||||||||||
2020 |
2019 |
2020 |
2019 |
|||||||||||||
Operating income (loss): |
||||||||||||||||
Managed care |
$ |
$ |
$ |
$ |
||||||||||||
Life insurance |
||||||||||||||||
Property and casualty insurance |
||||||||||||||||
Other segments * |
( |
) |
( |
) |
( |
) |
( |
) |
||||||||
Total business segments |
||||||||||||||||
TSM operating revenues from external sources |
||||||||||||||||
TSM unallocated operating expenses |
( |
) |
( |
) |
( |
) |
( |
) |
||||||||
Elimination of TSM intersegment charges |
||||||||||||||||
Consolidated operating income |
||||||||||||||||
Consolidated net realized investment gains (losses) |
( |
) |
||||||||||||||
Consolidated net unrealized investment gains (losses) on equity investments |
( |
) |
||||||||||||||
Consolidated interest expense |
( |
) |
( |
) |
( |
) |
( |
) |
||||||||
Consolidated other income, net |
||||||||||||||||
Consolidated income before taxes |
$ |
$ |
$ |
$ |
||||||||||||
Depreciation and amortization expense: |
||||||||||||||||
Managed care |
$ |
$ |
$ |
$ |
||||||||||||
Life insurance |
||||||||||||||||
Property and casualty insurance |
||||||||||||||||
Other segments* |
||||||||||||||||
Total business segments |
||||||||||||||||
TSM depreciation expense |
||||||||||||||||
Consolidated depreciation and amortization expense |
$ |
$ |
$ |
$ |
September 30, 2020 |
December 31, 2019 |
|||||||
Assets: |
||||||||
Managed care |
$ |
$ |
||||||
Life insurance |
||||||||
Property and casualty insurance |
||||||||
Other segments * |
||||||||
Total business segments |
||||||||
Unallocated amounts related to TSM: |
||||||||
Cash, cash equivalents, and investments |
||||||||
Property and equipment, net |
||||||||
Other assets |
||||||||
Elimination entries-intersegment receivables and others |
( |
) |
( |
) |
||||
Consolidated total assets |
$ |
$ |
Triple-S Management Corporation Notes to Condensed Consolidated Interim Financial Statements (dollar amounts in thousands, except per share data) (Unaudited) |
(19) | Subsequent Events |
As of September 30, |
||||||||
2020 |
2019 |
|||||||
Managed care enrollment: |
||||||||
Commercial 1 |
429,503 |
442,069 |
||||||
Medicare |
136,135 |
128,660 |
||||||
Medicaid |
385,344 |
354,230 |
||||||
Total |
950,982 |
924,959 |
||||||
Managed care enrollment by funding arrangement: |
||||||||
Fully insured |
843,152 |
805,882 |
||||||
Self-insured |
107,830 |
119,077 |
||||||
Total |
950,982 |
924,959 |
(1) | Commercial membership includes corporate accounts, self-funded employers, individual accounts, Medicare Supplement, Federal government employees and local government employees. |
Three months ended September 30, |
Nine months ended September 30, |
|||||||||||||||
(dollar amounts in millions) |
2020 |
2019 |
2020 |
2019 |
||||||||||||
Revenues: |
||||||||||||||||
Premiums earned, net |
$ |
923.0 |
$ |
815.0 |
$ |
2,657.4 |
$ |
2,442.5 |
||||||||
Administrative service fees |
3.7 |
2.6 |
8.7 |
7.7 |
||||||||||||
Net investment income |
14.2 |
15.2 |
42.3 |
45.6 |
||||||||||||
Other operating revenues |
2.0 |
3.1 |
6.4 |
6.3 |
||||||||||||
Total operating revenues |
942.9 |
835.9 |
2,714.8 |
2,502.1 |
||||||||||||
Net realized investment gains (losses) |
0.5 |
1.1 |
(0.2 |
) |
4.8 |
|||||||||||
Net unrealized investment gains (losses) on equity investments |
11.1 |
1.3 |
(17.4 |
) |
24.3 |
|||||||||||
Other income, net |
1.8 |
0.5 |
6.2 |
3.4 |
||||||||||||
Total revenues |
956.3 |
838.8 |
2,703.4 |
2,534.6 |
||||||||||||
Benefits and expenses: |
||||||||||||||||
Claims incurred |
761.8 |
680.0 |
2,129.4 |
2,009.5 |
||||||||||||
Operating expenses |
158.8 |
136.9 |
499.7 |
403.6 |
||||||||||||
Total operating expenses |
920.6 |
816.9 |
2,629.1 |
2,413.1 |
||||||||||||
Interest expense |
2.1 |
2.1 |
5.8 |
5.7 |
||||||||||||
Total benefits and expenses |
922.7 |
819.0 |
2,634.9 |
2,418.8 |
||||||||||||
Income before taxes |
33.6 |
19.8 |
68.5 |
115.8 |
||||||||||||
Income tax expense |
10.0 |
5.9 |
27.5 |
36.1 |
||||||||||||
Net income attributable to TSM |
$ |
23.6 |
$ |
13.9 |
$ |
41.0 |
$ |
79.7 |
Three months ended September 30, |
Nine months ended September 30, |
|||||||||||||||
(dollar amounts in millions) |
2020 |
2019 |
2020 |
2019 |
||||||||||||
Operating revenues: |
||||||||||||||||
Medical premiums earned, net: |
||||||||||||||||
Medicare |
$ |
400.7 |
$ |
367.1 |
$ |
1,160.9 |
$ |
1,065.7 |
||||||||
Medicaid |
240.9 |
176.3 |
682.9 |
577.7 |
||||||||||||
Commercial |
208.4 |
203.1 |
605.3 |
602.4 |
||||||||||||
Medical premiums earned, net |
850.0 |
746.5 |
2,449.1 |
2,245.8 |
||||||||||||
Administrative service fees |
3.1 |
3.6 |
9.8 |
10.9 |
||||||||||||
Net investment income |
5.1 |
5.7 |
14.8 |
17.0 |
||||||||||||
Total operating revenues |
858.2 |
755.8 |
2,473.7 |
2,273.7 |
||||||||||||
Medical operating costs: |
||||||||||||||||
Medical claims incurred |
720.3 |
645.2 |
2,025.1 |
1,905.9 |
||||||||||||
Medical operating expenses |
124.9 |
105.2 |
392.1 |
311.0 |
||||||||||||
Total medical operating costs |
845.2 |
750.4 |
2,417.2 |
2,216.9 |
||||||||||||
Medical operating income |
$ |
13.0 |
$ |
5.4 |
$ |
56.5 |
$ |
56.8 |
||||||||
Additional data: |
||||||||||||||||
Member months enrollment: |
||||||||||||||||
Commercial: |
||||||||||||||||
Fully insured |
966,906 |
964,321 |
2,920,460 |
2,872,836 |
||||||||||||
Self-funded |
324,372 |
356,059 |
981,634 |
1,072,510 |
||||||||||||
Total commercial |
1,291,278 |
1,320,380 |
3,902,094 |
3,945,346 |
||||||||||||
Medicare |
407,170 |
386,995 |
1,220,280 |
1,156,438 |
||||||||||||
Medicaid |
1,132,626 |
1,065,885 |
3,278,098 |
3,187,753 |
||||||||||||
Total member months |
2,831,074 |
2,773,260 |
8,400,472 |
8,289,537 |
||||||||||||
Medical loss ratio |
84.7 |
% |
86.4 |
% |
82.7 |
% |
84.9 |
% |
||||||||
Operating expense ratio |
14.6 |
% |
14.0 |
% |
15.9 |
% |
13.8 |
% |
• | Premiums generated by the Medicare business increased by $33.6 million, or 9.2%, to $400.7 million, mostly due to an increase in enrollment by approximately 20,000 member months, primarily reflecting a more competitive product offering, and higher average premium rates due to an increase in the average membership risk score. This quarter we also lowered the estimated MLR rebate accrual as utilization of services have continued to trend up to almost-normal levels following the reduction noted in the second quarter related to the lockdown as the result of the COVID-19 pandemic. |
• | Premiums generated by the Medicaid business increased by $64.6 million, or 36.6%, to $240.9 million, primarily reflecting higher member months of approximately 67,000 and higher average premium rates following three separate premium rate increases that became effective on November 1, 2019, May 1, 2020 and July 1, 2020. |
• | Premiums generated by the Commercial business increased by $5.3 million, or 2.6%, to $208.4 million, mainly reflecting higher average premium rates, an increase in fully insured member months during the quarter by approximately 3,000 and the reinstatement of the HIP fee pass-through in 2020. |
• | Claims incurred in the Medicare business increased by $25.5 million, or 8.6%, during the 2020 period and its MLR decreased 50 basis points to 80.6%. The increase in claims incurred is the result of higher membership offset by lower MLR. The lower MLR mostly reflects the increase in the average membership risk score and lower utilization resulting from the government-enforced lockdown during the COVID-19 pandemic, partially offset by unfavorable prior-period reserve development and a more competitive product offering. |
• | Claims incurred in the Medicaid business increased by $50.9 million, or 29.0%, during the 2020 period. The MLR, at 94.0%, was 560 basis points lower than the same period last year. The increase in claims incurred is the result of higher membership offset by lower MLR. The lower MLR mostly reflects the impact of the premium increases mentioned above, lower utilization resulting from the government-enforced lockdown during the COVID-19 pandemic, and the reinstatement of the HIP fee pass-through in 2020. These effects were partially offset by unfavorable prior-period reserve development. |
• | Claims incurred in the Commercial business decreased by $1.3 million, or 0.7%, during 2020 and its MLR decreased 280 basis points, to 81.9%. The lower MLR mostly reflects the reinstatement of the HIP fee pass-through in 2020, offset in part by unfavorable prior-period reserve development. |
• | Premiums generated by the Medicare business increased by $95.2 million, or 8.9%, to $1,160.9 million, mostly due to higher average premium rates, reflecting an increase in the average membership risk score revenue in 2020, and higher member months enrollment by approximately 64,000. These increases were partially offset by the recognition of an MLR rebate related to lower utilization following the government-enforced lock-down during the COVID-19 pandemic. |
• | Premiums generated by the Medicaid business increased by $105.2 million, or 18.2%, to $682.9 million, primarily reflecting higher average premium rates following the premium rates increases in 2020 mentioned above, an increase in enrollment of approximately 90,000 member months, the reinstatement of the HIP fee pass-through in 2020, and a profit-sharing accrual recorded in 2019. |
• | Premiums generated by the Commercial business increased by $2.9 million, or 0.5%, to $605.3 million. This fluctuation primarily reflects higher fully insured enrollment during the year by approximately 48,000 member months and the reinstatement of the HIP fee pass-through in 2020. These increases were partially offset by lower average premium rates and the recognition of an MLR rebate related to lower utilization following the government-enforced lockdown during the COVID-19 pandemic. |
• | Claims incurred in the Medicare business increased by $64.3 million, or 7.4%, during the 2020 period and its MLR decreased 120 basis points, to 80.2%. The increase in claim cost is due to higher member months, improved benefits in product offerings, and unfavorable prior-period reserve development, partially offset by the lower MLR. The lower MLR mostly reflects lower utilization of services as the result of the government-enforced lockdown during the COVID-19 pandemic, which was in force from mid-March to mid-June, when it was significantly reduced. |
• | Claims incurred in the Medicaid business increased by $93.2 million, or 17.3%, during 2020 and its MLR decreased 70 basis points, to 92.7%. The increase in claim cost is due to higher claims trend and member months and an unfavorable prior-period reserve development in 2020, partially offset by the lower MLR. The lower MLR reflects the higher premium rates in the 2020 period as well as the reinstatement of the HIP fee pass-through in 2020. In addition, the 2020 MLR reflects lower utilization of services as the result of the government-enforced lockdown during the COVID-19 pandemic. |
• | Claims incurred in the Commercial business decreased by $38.3 million, or 7.7%, during 2020 and its MLR decreased 670 basis points, to 76.1%. These decreases mostly result from lower utilization related to the COVID-19 lockdown and the impact in the MLR of the reinstatement of the HIP fee pass-through in 2020. These decreases were partially offset by the impact of the previously mentioned estimated premium rebates, higher fully insured enrollment and an unfavorable change in prior-period reserve developments when compared to the 2019 period. |
Three months ended September 30, |
Nine months ended September 30, |
|||||||||||||||
(dollar amounts in millions) |
2020 |
2019 |
2020 |
2019 |
||||||||||||
Operating revenues: |
||||||||||||||||
Premiums earned, net: |
||||||||||||||||
Premiums earned |
$ |
52.6 |
$ |
47.3 |
$ |
152.2 |
$ |
139.7 |
||||||||
Assumed earned premiums |
0.1 |
0.6 |
0.1 |
1.6 |
||||||||||||
Ceded premiums earned |
(2.6 |
) |
(2.1 |
) |
(7.4 |
) |
(6.2 |
) |
||||||||
Premiums earned, net |
50.1 |
45.8 |
144.9 |
135.1 |
||||||||||||
Net investment income |
6.9 |
6.7 |
20.6 |
20.0 |
||||||||||||
Total operating revenues |
57.0 |
52.5 |
165.5 |
155.1 |
||||||||||||
Operating costs: |
||||||||||||||||
Policy benefits and claims incurred |
30.6 |
25.9 |
78.6 |
79.2 |
||||||||||||
Underwriting and other expenses |
20.7 |
20.0 |
66.7 |
58.4 |
||||||||||||
Total operating costs |
51.3 |
45.9 |
145.3 |
137.6 |
||||||||||||
Operating income |
$ |
5.7 |
$ |
6.6 |
$ |
20.2 |
$ |
17.5 |
||||||||
Additional data: |
||||||||||||||||
Loss ratio |
61.1 |
% |
56.6 |
% |
54.2 |
% |
58.6 |
% |
||||||||
Operating expense ratio |
41.3 |
% |
43.7 |
% |
46.0 |
% |
43.2 |
% |
Three months ended September 30, |
Nine months ended September 30, |
|||||||||||||||
(dollar amounts in millions) |
2020 |
2019 |
2020 |
2019 |
||||||||||||
Operating revenues: |
||||||||||||||||
Premiums earned, net: |
||||||||||||||||
Premiums written |
$ |
44.0 |
$ |
40.0 |
$ |
115.6 |
$ |
107.4 |
||||||||
Premiums ceded |
(14.9 |
) |
(12.3 |
) |
(45.6 |
) |
(36.0 |
) |
||||||||
Change in unearned premiums |
(5.2 |
) |
(4.0 |
) |
(3.1 |
) |
(6.5 |
) |
||||||||
Premiums earned, net |
23.9 |
23.7 |
66.9 |
64.9 |
||||||||||||
Net investment income |
2.2 |
2.5 |
6.6 |
7.4 |
||||||||||||
Total operating revenues |
26.1 |
26.2 |
73.5 |
72.3 |
||||||||||||
Operating costs: |
||||||||||||||||
Claims incurred |
10.4 |
10.2 |
27.8 |
28.3 |
||||||||||||
Underwriting and other expenses |
11.3 |
9.4 |
34.8 |
29.1 |
||||||||||||
Total operating costs |
21.7 |
19.6 |
62.6 |
57.4 |
||||||||||||
Operating income |
$ |
4.4 |
$ |
6.6 |
$ |
10.9 |
$ |
14.9 |
||||||||
Additional data: |
||||||||||||||||
Loss ratio |
43.5 |
% |
43.0 |
% |
41.6 |
% |
43.6 |
% |
||||||||
Operating expense ratio |
47.3 |
% |
39.7 |
% |
52.0 |
% |
44.8 |
% |
Nine months ended September 30, |
||||||||
(dollar amounts in millions) |
2020 |
2019 |
||||||
Sources (uses) of cash: |
||||||||
Cash provided by (used in) operating activities |
$ |
223.7 |
$ |
(3.5 |
) |
|||
Net (purchases) proceeds of investment securities |
(211.7 |
) |
0.7 |
|||||
Net capital expenditures |
(52.5 |
) |
(14.7 |
) |
||||
Capital contribution on equity method investees |
(7.1 |
) |
- |
|||||
Proceeds from long-term borrowings |
30.9 |
- |
||||||
Net change in short-term borrowings |
28.5 |
- |
||||||
Payments of long-term borrowings |
(2.8 |
) |
(2.4 |
) |
||||
Proceeds from policyholder deposits |
21.6 |
15.1 |
||||||
Surrenders of policyholder deposits |
(12.8 |
) |
(16.5 |
) |
||||
Repurchase and retirement of common stock |
(14.9 |
) |
- |
|||||
Other |
16.9 |
2.7 |
||||||
Net increase (decrease) in cash and cash equivalents |
$ |
19.8 |
$ |
(18.6 |
) |
(Dollar amounts in millions, except per share data) |
Total Number of Shares Purchased (1) |
Average Price Paid per Share |
Total Number of Shares Purchased as Part of Publicly Announced Programs |
Approximate Dollar Value of Shares that May Yet Be Purchased Under the Programs |
||||||||||||
July 1, 2020 to July 31, 2020 |
- |
$ |
- |
- |
$ |
- |
||||||||||
August 1, 2020 to August 31, 2020 |
- |
- |
- |
- |
||||||||||||
September 1, 2020 to September 30, 2020 |
14,040 |
18.85 |
- |
- |
Exhibits |
Description |
Amendment to the contract between Administración de Seguros de Salud de Puerto Rico (ASES) and Triple-S Salud, Inc., to administer the Provision of Physical & Behavioral Health Services under the Government Health Plan dated as of August 28, 2020. |
|
Amendment to the contract between Administración de Seguros de Salud de Puerto Rico (ASES) and Triple-S Salud, Inc., to administer the Provision of Physical & Behavioral Health Services under the Government Health Plan dated as of September 9, 2020. |
|
Amendment to the contract between Administración de Seguros de Salud de Puerto Rico (ASES) and Triple-S Salud, Inc., to administer the Provision of Physical & Behavioral Health Services under the Government Health Plan dated as of September 24, 2020. |
|
Statement re computation of per share earnings; an exhibit describing the computation of the earnings per share for the three and nine months ended September 30, 2020 and 2019 has been omitted as the detail necessary to determine the computation of earnings per share can be clearly determined from the material contained in Part I of this Quarterly Report on Form 10-Q. |
|
Certification of the President and Chief Executive Officer required by Rule 13a-14(a)/15d-14(a). |
|
Certification of the Executive Vice President and Chief Financial Officer required by Rule 13a-14(a)/15d-14(a). |
|
Certification of the President and Chief Executive Officer required pursuant to 18 U.S.C Section 1350. |
|
Certification of the Executive Vice President and Chief Financial Officer required pursuant to 18 U.S.C Section 1350. |
Triple-S Management Corporation |
|||||
Registrant |
|||||
Date: |
November 6, 2020 |
By: |
/s/ Roberto García-Rodríguez |
||
Roberto García-Rodríguez |
|||||
President and Chief Executive Officer |
|||||
Date: |
November 6, 2020 |
By: |
/s/ Juan J. Román-Jiménez |
||
Juan J. Román-Jiménez |
|||||
Executive Vice President and Chief Financial Officer |
I. |
AMENDMENTS
|
1. |
Section 21.4.1 shall be amended as follows:
|
21.4.1 |
Notwithstanding anything to the contrary in this Contract, because the Parties have not completed the revision of the PMPM Payments by the expiration of the current rating period
which ended on June 30, 2020 (the “Expired Rating Period”) such that the new rating period must commence without revised PMPM Payments, then the following shall occur:
|
21.4.1.1 |
ASES shall continue to pay Contractors at the PMPM Payment rates that existed during the Expired Rating Period;
|
21.4.1.2 |
As soon as practicable, but in no event more than seventy (70) days following the expiration of the Expired Rating Period, or sooner if the revised PMPM Payments (“Updated PMPM
Payments”) become available, the Parties shall complete in good faith the review of the Updated PMPM Payments.
|
21.4.1.3 |
Following agreement upon the Updated PMPM Payments, the Parties shall execute an amendment to Attachment 11 of the Contract setting forth the Updated PMPM Payments. Such amendment
and the Updated PMPM Payments shall be effective as of July 1st, 2020 as if the Updated PMPM Payments had been agreed upon at the expiration of the Expired Rating Period, provided that,
|
21.4.1.3.1 |
Notwithstanding the foregoing, because Updated PMPM Payments are subject to CMS and the Financial Oversight and Management Board (“FOMB”) approval, ASES will continue to pay
Contractors at the PMPM Payment rates that existed during the Expired Rating Period until such time as CMS and the FOMB have approved the Updated PMPM Payments, and;
|
21.4.1.3.2 |
Within thirty (30) calendar days following CMS’s and the FOMB’s approval of the Updated PMPM Payments, the Parties shall begin to reconcile any difference between (i) PMPM Payments
that ASES made to Contractors after the Expired Rating Period and (ii) Updated PMPM Payments.
|
II. |
RATIFICATION
|
III. |
EFFECT; CMS APPROVAL
|
IV. |
AMENDMENT EFFECTIVE DATE
|
V. |
ENTIRE AGREEMENT
|
/s/ Jorge E. Galva Rodríguez
|
8/28/2020
|
||
Name: Jorge E. Galva Rodríguez, JD, MHA
|
Date
|
||
EIN: 66-05000678
|
/s/ Madeline Hernández Urquiza
|
8/28/2020
|
||
Ms. Madeline Hernández Urquiza, President
|
Date
|
||
EIN: 66-0555677
|
I. |
AMENDMENTS
|
1. |
Section 21.4.1 shall be amended as follows:
|
21.4.1 |
Notwithstanding anything to the contrary in this Contract, because the Parties have not completed the revision of the PMPM Payments by the expiration of the current rating period which ended on June 30, 2020 (the “Expired Rating Period”)
such that the new rating period must commence without revised PMPM Payments, then the following shall occur:
|
21.4.1.1 |
ASES shall continue to pay Contractors at the PMPM Payment rates that existed during the Expired Rating Period;
|
21.4.1.2 |
As soon as practicable, but in no event more than seventy seven (77) days following the expiration of the Expired Rating Period, or sooner if the revised PMPM Payments (“Updated PMPM Payments”) become available, the Parties shall
complete in good faith the review of the Updated PMPM Payments.
|
21.4.1.3 |
Following agreement upon the Updated PMPM Payments, the Parties shall execute an amendment to Attachment 11 of the Contract setting forth the Updated PMPM Payments. Such amendment and the Updated PMPM Payments shall be effective as of
July 1st, 2020 as if the Updated PMPM Payments had been agreed upon at the expiration of the Expired Rating Period, provided that,
|
21.4.1.3.1 |
Notwithstanding the foregoing, because Updated PMPM Payments are subject to CMS and the Financial Oversight and Management Board (“FOMB”) approval, ASES will continue to pay Contractors at the PMPM Payment rates that existed during the
Expired Rating Period until such time as CMS and the FOMB have approved the Updated PMPM Payments, and;
|
21.4.1.3.2 |
Within thirty (30) calendar days following CMS’s and the FOMB’s approval of the Updated PMPM Payments, the Parties shall begin to reconcile any difference between (i) PMPM Payments that ASES made to Contractors after the Expired Rating
Period and (ii) Updated PMPM Payments.
|
II. |
RATIFICATION
|
III. |
EFFECT; CMS APPROVAL
|
IV. |
AMENDMENT EFFECTIVE DATE
|
V. |
ENTIRE AGREEMENT
|
/s/ Jorge E. Galva Rodríguez
|
9/9/2020
|
||
Name: Jorge E. Galva Rodríguez, JD, MHA
|
Date
|
||
EIN: 66-05000678
|
_/s/ Madeline Hernández Urquiza
|
9/9/2020
|
||
Ms. Madeline Hernández Urquiza, President
|
Date
|
||
EIN: 66-0555677
|
I.
|
AMENDMENTS
|
1. |
The definition for “Sub-capitated” in Article 2 shall be deleted in its entirety.
|
2. |
The definition for “Encounter” in Article 2 shall be amended and replaced in its entirety as follows:
|
3. |
The following definitions in Article 2 shall be inserted as follows:
|
4. |
Immediately following Section 7.1.5, a new Section 7.1.6 shall be inserted stating as follows:
|
7.1.6 |
The availability of health care services through Telehealth, Telemedicine, and Teledentistry is a matter of public policy that must be developed and made operational by the Contractor and Providers. As a
general principle, ASES will treat Telemedicine and telehealth services on equal footing as in-person services, providing for the required adjustment in reimbursement when appropriate and for the establishment of necessary oversight by the
Contractor. Subject to the foregoing, the Contractor shall allow Providers to conduct patient re-assessments and provide clinically appropriate care via the use of Telemedicine and Teledentistry, in accordance with Puerto Rico law and any
applicable federal requirements governing such activity.
|
5. |
Immediately following Section 7.5.3.2.1.2, a new Section 7.5.3.2.1.3 shall be inserted stating as follows:
|
7.5.3.2.1.3 |
The Contractor shall cover the immunization of all Enrollees against COVID-19. COVID-19 vaccine costs are not considered in the current premium. When a COVID-19 vaccine becomes available, ASES shall procure
an actuarial analysis to calculate any necessary changes to PMPM Payment rates. Any changes to PMPM payment rates will be retroactively adjusted as of the date the Contractor began to cover the treatment.
|
6. |
Immediately following Section 7.5.6.1.18, a new Section 7.5.6.1.19 shall be inserted stating as follows:
|
7.5.6.1.19 |
The use of Veklury (remdesivir) as medically necessary for the treatment of hospitalized adult and pediatric Enrollees with suspected or laboratory-confirmed COVID-19, in accordance with FDA guidance. The
costs of such drug and/or treatment shall be reimbursed by ASES separately from PMPM Payments.
|
7. |
Section 7.5.12.3.1 shall be deleted in its entirety, and the remaining Section 7.5.12.3 shall be renumbered accordingly, including any references thereto.
|
8. |
Section 7.7.11.16 shall be amended and replaced in its entirety as follows:
|
7.7.11.16 |
Required medication for the outpatient treatment of Hepatitis C is included under Special Coverage. Any costs incurred for required medication for the outpatient treatment of Hepatitis C shall be funded
through separate payment by ASES to PBM. Medication for the outpatient treatment for AIDS-diagnosed Enrollees or HIV-positive Enrollees is also included under Special Coverage and are provided by ADAP. Protease inhibitors are excluded from
the covered services are provided by CPTET Centers.
|
9. |
Section 7.5.12.15.1 shall be amended and replaced in its entirety as follows:
|
7.5.12.15.1 |
The Contractor shall select two (2) members of its staff to serve on a cross-functional committee, the Pharmacy Benefit Financial Committee, tasked with rebate maximization and/or evaluating recommendations
regarding the FMC and LME from the P&T Committee and the PPA and PBM as applicable. The Pharmacy Benefit Financial Committee will also review the FMC and LME from time to time and evaluate additional recommendations on potential
cost-saving pharmacy initiatives, including the evaluation of the utilization of high-cost specialty medications and orphan drugs and the exceptions process through which such drugs are approved, under the direction and approval of ASES.
The Pharmacy Benefit Financial Committee will meet not later than thirty (30) days after the execution of this Amendment and monthly thereafter.
|
10. |
Section 10.3.1.14 shall be amended and replaced in its entirety as follows:
|
10.3.1.14 |
Require the Provider to cooperate with the Contractor’s quality improvement and Utilization Management activities, including those activities set forth in the HCIP, and any related reporting. Contractor is
not permitted to grant any individual Provider an exception to the requirements under this Section;
|
11. |
Immediately following Section 10.3.2.1.6, a new Section 10.3.2.1.7 shall be inserted stating as follows:
|
10.3.2.1.7 |
Require PMGs reimbursed by Contractor under a Subcapitated Arrangement to certify that the PMG has passed through any increase of Subcapitated amounts to its affiliated physicians. ASES and Contractor shall
track any complaints filed by PMG-affiliated physicians and conduct the appropriate investigation and diligence to ensure compliance with this section. The Contractor shall provide to ASES an attestation to certify compliance with this
section. If PMGs refuse to certify the pass-through of the increase of Subcapitated amounts to its affiliated physicians, or otherwise fail to comply with this section’s requirements, Contractor may escalate the issue to ASES and shall not
be obligated to remit to impacted PMGs the increased amounts set forth under Section 10.5.1.5.3 until ASES has resolved the issue.
|
12. |
Section 10.5.1.5.1 shall be amended and replaced in its entirety as follows:
|
10.5.1.5.1 |
Claims submitted for professional services that are listed in the current Medicare Part B fee schedule, as established under Section 1848(b) of the Social Security Act, and as applicable to Puerto Rico for
2020 (70% MFS), shall be reimbursed by the Contractor at not less than seventy percent (70%) of the payment that would apply to covered services and benefits, if they were furnished under Medicare Part B, disregarding services that are paid
through Subcapitation Arrangements. Any claims subject to reimbursement in accordance with this Section 10.5.1.5.1 that have been reimbursed at less than seventy percent (70%) of the corresponding rates on the Medicare Part B fee schedule
shall be re-adjudicated for payment in compliance with this Section. In the event the MCO and the provider have a contracted rate greater than the 70% at the time of this Amendment, the MCO may (i) maintain the current rate contracted with
the provider for the effectiveness of that agreement, or (ii) contract a different rate as long as such rate is 70% MFS or higher. The Contractor shall comply with all data collection and reporting requests from ASES, in the manner and
frequency set forth by ASES, to validate the Contractor’s compliance with this Section.
|
13. |
Immediately following Section 10.5.1.5.2, new Sections 10.5.1.5.3, 10.5.1.5.4, and 10.5.1.5.5 shall be inserted stating as follows:
|
10.5.1.5.3 |
Contractor must increase payments to PMGs under a Subcapitated Arrangement from July 1, 2020. Contractor must remit the full increased amount to impacted PMGs. Subcapitation Arrangements shall not be subject
to the requirements set forth in Section 10.5.1.5.1 and 10.5.1.5.2.
|
10.5.1.5.4 |
Contractors shall collaborate with ASES in good faith to adopt a DRG reimbursement methodology for hospitals within the timeframe specified by ASES. In addition, Contractors shall engage in good faith with
the Provider community and ASES to identify providers and services that should be subject to future implementation of alternative payment methodologies (APMs) that align with Medicare APMs and/or the Health Care Payment Learning and Action
Network (LAN) framework for classifying APMs to derive value and improved outcomes for the Plan Vital population. The Contractor shall identify dedicated staff to engage in these efforts and participate in meetings convened by ASES. ASES
will adjust the PMPM rates to reflect the changes after said rates are approved by CMS.
|
10.5.1.5.5 |
Contractor shall make directed payments to qualifying short-term acute care hospitals in the amount and frequency set forth by ASES. Contractor shall make those payments as soon as ASES disburses such
payments to the Contractor. Such directed payments shall reflect a uniform dollar increase per All Patient Refined Diagnosis Related Groups (APR-DRG) case-mix adjusted discharges for qualifying public and private short-term acute care
hospitals. Such increases shall be funded through payments disbursed by ASES to Contractor as lump sum amounts payable throughout the year, quarterly or with the frequency mandated by ASES, and separate from PMPM Payments. Contractor shall
cooperate in any efforts made by ASES to reconcile projected and actual APR-DRG case-mix adjusted discharges, including but not limited to complying with all data collection and reporting requests from ASES, in the manner and frequency set
forth by ASES, and any required, post-reconciliation recoupment of directed payments previously made to qualifying short-term acute care hospitals.
|
14. |
Section 10.6.2 shall be amended and replaced in its entirety as follows:
|
10.6.2 |
The Contractor shall ensure that PMGs subject to a Subcapitation Arrangement with the Contractor are not responsible for the difference between current fee for service reimbursements for which the PMG is At
Risk and increases in reimbursement amounts necessary to meet new minimum reimbursement thresholds, established at Section 10.5.1.5.1, unless a new Subcapitation Arrangement is negotiated between and agreed upon by the Contractor and the
PMG to account for said increase.
|
15. |
Section 12.5.1 shall be amended and replaced in its entirety as follows:
|
12.5.1 |
The HCIP consists of four (4) initiatives subject to performance indicators specified in the Health Care Improvement Program Manual (“HCIP Manual”), Attachment 19 to this Contract. The initiatives and
accompanying performance indicators and measurement periods for the Contract Term are further defined in the HCIP Manual.
|
16. |
Immediately following Section 12.8.4 a new Section 12.9 shall be inserted stating as follows:
|
12.9
|
Comprehensive Oversight and Monitoring Plan (COMP)
|
12.9.1 |
The Comprehensive Oversight and Monitoring Plan (“COMP”) as developed and implemented by ASES pursuant to federal requirements, sets forth clinical, operational and financial performance metrics and
benchmarks to evaluate the efficiency, type and volume of care provided to Enrollees by all MCOs. As part of this oversight effort, Contractor shall timely comply with all ASES requests for COMP reporting and data collection as well as
operational reviews, corrective action and targeted interventions as deemed necessary based on ASES’s review of such COMP reports and data. ASES shall issue further guidance as to Contractor’s expectations and obligations under the COMP.
Should COMP requirements materially impact the obligations of Contractor under this Contract, ASES shall seek an amendment to this Contract to accommodate said requirement.
|
17. |
Section 13.1.6 shall be amended and replaced in its entirety as follows:
|
13.1.6 |
The Contractor shall submit its proposed compliance plan, Fraud, Waste, and Abuse policies and procedures, and its program integrity plan to ASES for prior written approval according to the timeframe
specified in Attachment 12 to this Contract.
|
18.
|
Section 13.1.7 shall be amended and replaced in its entirety as follows:
|
13.1.7 |
Any changes to the Contractor’s written compliance plan or Fraud, Waste, and Abuse policies and procedures shall be submitted to ASES for approval within fifteen (15) Calendar Days of the date the Contractor
plans to implement the changes and the changes shall not go into effect until ASES provides prior written approval.
|
19. |
Immediately following Section 13.1.11 a new Section 13.1.12 shall be inserted stating as follows:
|
13.1.12 |
The Contractor shall participate in any efforts by ASES, the Medicaid Program Integrity Office, or the Medicaid Fraud Control Unit to engage MCOs and facilitate outreach, discussion and coordination on Fraud,
Waste and Abuse prevention, including attendance at meetings and trainings covering Fraud, Waste and Abuse prevention and detection techniques and best practices. ASES, the Medicaid Program Integrity Office and Medicaid Fraud Control Unit
preserve the right to directly pursue Fraud, Waste and Abuse efforts, in the event of any noncompliance by the Contractor. Likewise, should Medicaid Program Integrity Office or Medicaid Fraud Control Unit for any reason decide to not pursue
cases referred, ASES shall address such cases according to the terms and conditions of the Contract. Such efforts and other compliance activities shall be conducted by ASES, the Medicaid Program Integrity Office and the Medicaid Fraud
Control Unit in accordance with the signed Memorandum of Understanding between the agencies.
|
20. |
Section 13.2 shall be amended and replaced in its entirety as follows:
|
13.2 |
Effective Compliance Program
|
13.2.1 |
The Contractor shall implement an effective compliance program. The program’s goals and objectives, scope, and methodology to evaluate program performance shall be documented in a comprehensive compliance
plan to be maintained and updated by Contractor. A paper and electronic copy of the compliance plan shall be provided to ASES annually for prior written approval. ASES shall provide notice of approval, denial, or modification to the
Contractor within thirty (30) Calendar Days of receipt. The Contractor shall make any necessary changes required by ASES within an additional thirty (30) Calendar Days of the request.
|
13.2.2 |
At a minimum, the Contractor’s compliance program shall, in accordance with 42 CFR 438.608 and the U.S. Department of Justice’s Federal Sentencing Guidelines:
|
13.2.2.1 |
Ensure that all of its officers, directors, managers and employees know and understand the elements of the Contractor’s compliance program;
|
13.2.2.2 |
Require the designation of a compliance officer and a compliance committee that are accountable to the Contractor’s senior management. The compliance officer shall have express authority to provide unfiltered
reports directly to the Contractor’s most senior leader and governing body;
|
13.2.2.3 |
Ensure and describe effective training and education for the compliance officer and the Contractor’s employees;
|
13.2.2.4 |
Ensure that Providers and Enrollees are educated about Fraud, Waste, and Abuse identification and reporting in the materials provided to them;
|
13.2.2.5 |
Ensure effective lines of communication between the Contractor’s compliance officer and the Contractor’s employees to ensure that employees understand and comply with the Contractor’s compliance program;
|
13.2.2.6 |
Ensure enforcement of standards of conduct through well-publicized disciplinary guidelines;
|
13.2.2.7 |
Ensure internal monitoring and auditing with provisions for prompt response to potential offenses, along with the prompt referral of any such offenses to MFCU, and for the development of corrective action
initiatives relating to the Contractor’s compliance efforts;
|
13.2.2.8 |
Describe standards of conduct that articulate the Contractor’s commitment to comply with all applicable Puerto Rico and Federal requirements and standards;
|
13.2.2.9 |
Ensure that no individual who reports Provider violations or suspected cases of Fraud, Waste, and Abuse is retaliated against; and
|
13.2.2.10 |
Include a monitoring program that is designed to prevent and detect potential or suspected Fraud, Waste, and Abuse. This monitoring program shall include but not be limited to:
|
13.2.2.10.1 |
Monitoring the billings of its Providers to ensure Enrollees receive services for which the Contractor is billed;
|
13.2.2.10.2 |
Requiring the investigation of all reports of suspected cases of Fraud and over-billings;
|
13.2.2.10.3 |
Reviewing Providers for over, under and inappropriate Utilization;
|
13.2.2.10.4 |
Verifying with Enrollees the delivery of services as claimed; and
|
13.2.2.10.5 |
Reviewing and trending Enrollee Complaints regarding Providers.
|
13.2.3 |
The Contractor, and any Subcontractors delegated the responsibility by the Contractor for coverage of services and payment of claims under this Contract, shall include in all employee handbooks a specific
discussion of the False Claims Act and its Fraud, Waste, and Abuse policies and procedures, the rights of employees to be protected as whistleblowers, and the Contractor and Subcontractor’s procedures for detecting and preventing Fraud,
Waste, and Abuse.
|
13.2.4 |
The Contractor shall include in the Enrollee Handbook, as set forth by ASES, a description of its compliance program, instructions on how to report Fraud, Waste, and Abuse, and the protections for
whistleblowers.
|
21. |
Section 13.3.1.7 shall be amended and replaced in its entirety as follows:
|
13.3.1.7 |
Defines mechanisms, including automated mechanisms, to monitor frequency of Encounters and services rendered to Enrollees billed by Providers, and to flag suspicious activity and potential incidents of Fraud,
Waste and Abuse that warrant further investigation;
|
22. |
Section 16.1.6 shall be amended and replaced in its entirety as follows:
|
16.1.6 |
To be processed, all Claims submitted for payment shall comply with the Clean Claim standards as established by Federal regulation (42 CFR 447.46), and with the standards described in Section 16.6.2 of this
Contract.
|
23. |
Section 18.2.2.8. shall be amended in its entirety as follows:
|
18.2.2.8 |
The Contractor shall submit a monthly HCHN Pre-Registry Report for ASES to process monthly PMPM Payments. The report shall provide information on all HCHN Enrollees that are identified by the Contractor
following the procedures established in Attachment 28 to this Contract.
|
24. |
Section 22.1.1.2 shall be amended and replaced in its entirety as follows:
|
22.1.1.2 |
PMPM Payment rates included in Attachments 11 and 11-A to this Contract, as amended, shall be effective to account for any new requirements set forth in Sections 10.5.1.5.1 and 10.5.1.5.2. ASES will increase
the PMPM Payments to account for the additional costs incurred by Contractor with respect to the minimum fee schedule and increase in Subcapitated amounts, as of the effective date of the Amendment.
|
25. |
Section 22.3.1 shall be amended and replaced in its entirety as follows:
|
22.3.1 |
If the Contractor wishes to contest the amount of payments made by ASES in accordance with the terms outlined in Section 22.1 for services provided under the terms of this Contract, the Contractor shall
submit to ASES, in the format defined by ASES, all relevant documentation supporting the Contractor’s objection no later than (90) Calendar Days after payment is made. In the event ASES notifies changes to the files or file layouts
necessary for payment reconciliation, the term for submitting an objection to payment shall start to run sixty (60) days after notice of changes to the files or file layouts has been issued by ASES. Once this term has ended, the Contractor
forfeits its right to claim any additional amounts, regarding the period in dispute. The terms specified in this Section 22.3.1 shall be applicable from this Amendment’s effective date.
|
22.3.2 |
Within thirty (30) Calendar Days after the Contractor’s submission of all relevant information, the Contractor and ASES will meet to discuss the matter. If after discussing the matter and analyzing all
relevant Data it is subsequently determined that an error in payment was made, the Contractor and ASES will develop a plan to remedy the situation, which must include a timeframe for resolution agreed to by both Parties, within a time
period mutually agreed upon by both Parties. The remedial plan for any error in payment or ASES’ response to the Contractor’s objection to payment will be reduced to writing within ninety (90) Calendar Days from the date the objection was
submitted by the Contractor. The total resolution and payment for the cases objected to and accepted by ASES shall not exceed one-hundred eighty (180) days from the date on which Contractor submitted the objection. The terms specified in
this Section 22.3.1 shall be applicable from this Amendment’s effective date.
|
26. |
Section 23.3.4 shall be amended and replaced in its entirety as follows:
|
23.3.4 |
The Contractor’s stop-loss responsibility shall not be transferred to a PMG unless the PMG and the Contractor expressly agree in writing to the PMG’s assuming this risk. In this event, Contractor shall
evaluate and accept any stop-loss insurance and reinsurance obtained by the PMG from a licensed insurer or reinsurer that meets agreed-upon coverage amounts and other requirements, and shall neither refuse to accept such qualifying coverage
nor obligate the PMG to utilize insurance provided by the Contractor. Stop-loss and reinsurance coverage must comply with Puerto Rico insurance law, as applicable.
|
27. |
Section 38.2.3 shall be amended and replaced in its entirety as follows:
|
38.2.3 |
At the request of either party, ASES will evaluate any enacted Federal, state or local legislative or regulatory changes with applicability to the GHIP program that materially impact the PMPM Payment. If
after a process of actuarial evaluation, using credible data, ASES determines that the enacted legislative and/or regulatory changes materially impact the PMPM Payment, ASES will adjust the PMPM rates to reflect the above-referenced changes
after the adjusted rates are approved by CMS. Any revisions to the PMPM Payments under this Section would be applicable from November 1, 2018 until October 31, 2019, from the effective date of any new law or regulation, whichever is later,
and with the review and approval from FOMB in the event said review and approval is applicable. “Materially impact” shall mean that a recalculation of current PMPM Payments is required in order to remain actuarially sound.
|
28. |
Attachment 9 shall be renamed as follows:
|
29. |
The following amended attachments, copies of which are included, are substituted in this Contract as follows:
|
ATTACHMENT 7:
|
UNIFORM GUIDE FOR SPECIAL COVERAGE
|
ATTACHMENT 11:
|
PER MEMBER PER MONTH PAYMENTS
|
ATTACHMENT 19:
|
HEALTH CARE IMPROVEMENT PROGRAM (HCIP) MANUAL
|
ATTACHMENT 27:
|
POLICY FOR MEDICATION EXCEPTION REQUESTS
|
ATTACHMENT 28:
|
HCHN RATE CELLS
|
II. |
RATIFICATION
|
III. |
EFFECT; CMS and FOMB APPROVAL
|
IV. |
AMENDMENT EFFECTIVE DATE
|
V. |
ENTIRE AGREEMENT
|
/s/ Jorge E. Galva Rodríguez
|
9/24/2020
|
||
Name: Jorge E. Galva Rodríguez, JD, MHA
|
Date
|
||
EIN: 66-05000678
|
/s/ Madeline Hernández Urquiza
|
9/24/2020
|
||
Ms. Madeline Hernández Urquiza, President
|
Date
|
||
EIN: 66-0555677
|
1. |
I have reviewed this quarterly report on Form 10-Q of Triple-S Management Corporation;
|
2. |
Based on my knowledge, this report does not contain any untrue statement of a material fact or omit to state a material fact necessary to make the statements made,
in light of the circumstances under which such statements were made, not misleading with respect to the period covered by this report;
|
3. |
Based on my knowledge, the financial statements, and other financial information included in this report, fairly present in all material respects the financial
condition, results of operations and cash flows of the registrant as of, and for, the periods presented in this report;
|
4. |
The registrant’s other certifying officers and I are responsible for establishing and maintaining disclosure controls and procedures (as defined in Exchange Act
Rules 13a-15(e) and 15d-15(e)) and internal control over financial reporting (as defined in Exchange Act Rules 13a-15(f) and 15d-15(f)) for the registrant and have:
|
a. |
Designed such disclosure controls and procedures, or caused such disclosure controls and procedures to be designed under our supervision, to ensure that material
information relating to the registrant, including its consolidated subsidiaries, is made known to us by others within those entities, particularly during the period in which this report is being prepared;
|
b. |
Designed such internal control over financial reporting, or caused such internal control over financial reporting to be designed under our supervision, to provide
reasonable assurance regarding the reliability of financial reporting and the preparation of financial statements for external purposes in accordance with generally accepted accounting principles;
|
c. |
Evaluated the effectiveness of the registrant’s disclosure controls and procedures and presented in this report our conclusions about the effectiveness of the
disclosure controls and procedures, as of the end of the period covered by this report based on such evaluation; and
|
d. |
Disclosed in this report any change in the registrant’s internal control over financial reporting that occurred during the registrant’s most recent fiscal quarter
that has materially affected, or is reasonably likely to materially affect, the registrant’s internal control over financial reporting; and
|
5. |
The registrant’s other certifying officers and I have disclosed, based on our most recent evaluation of internal control over financial reporting, to the
registrant’s auditors and the audit committee of the registrant’s board of directors (or persons performing the equivalent functions):
|
a. |
All significant deficiencies and material weaknesses in the design or operation of internal control over financial reporting which are reasonably likely to
adversely affect the registrant’s ability to record, process, summarize and report financial information; and
|
b. |
Any fraud, whether or not material, that involves management or other employees who have a significant role in the registrant’s internal control over financial
reporting.
|
Date:
|
November 6, 2020
|
By:
|
/s/ Roberto García-Rodríguez
|
||
Roberto García-Rodríguez
|
|||||
President and Chief Executive Officer
|
1. |
I have reviewed this quarterly report on Form 10-Q of Triple-S Management Corporation;
|
2. |
Based on my knowledge, this report does not contain any untrue statement of a material fact or omit to state a material fact necessary to make the statements made, in light of the circumstances under which such
statements were made, not misleading with respect to the period covered by this report;
|
3. |
Based on my knowledge, the financial statements, and other financial information included in this report, fairly present in all material respects the financial condition, results of operations and cash flows of
the registrant as of, and for, the periods presented in this report;
|
4. |
The registrant’s other certifying officers and I are responsible for establishing and maintaining disclosure controls and procedures (as defined in Exchange Act Rules 13a-15(e) and 15d-15(e)) and internal
control over financial reporting (as defined in Exchange Act Rules 13a-15(f) and 15d-15(f)) for the registrant and have:
|
a) |
Designed such disclosure controls and procedures, or caused such disclosure controls and procedures to be designed under our supervision, to ensure that material information relating to the registrant, including
its consolidated subsidiaries, is made known to us by others within those entities, particularly during the period in which this report is being prepared;
|
b) |
Designed such internal control over financial reporting, or caused such internal control over financial reporting to be designed under our supervision, to provide reasonable assurance regarding the reliability
of financial reporting and the preparation of financial statements for external purposes in accordance with generally accepted accounting principles;
|
c) |
Evaluated the effectiveness of the registrant’s disclosure controls and procedures and presented in this report our conclusions about the effectiveness of the disclosure controls and procedures, as of the end of
the period covered by this report based on such evaluation; and
|
d) |
Disclosed in this report any change in the registrant’s internal control over financial reporting that occurred during the registrant’s most recent fiscal quarter that has materially affected, or is reasonably
likely to materially affect, the registrant’s internal control over financial reporting; and
|
5. |
The registrant’s other certifying officers and I have disclosed, based on our most recent evaluation of internal control over financial reporting, to the registrant’s auditors and the audit committee of the
registrant’s board of directors (or persons performing the equivalent functions):
|
a) |
All significant deficiencies and material weaknesses in the design or operation of internal control over financial reporting which are reasonably likely to adversely affect the registrant’s ability to record,
process, summarize and report financial information; and
|
b) |
Any fraud, whether or not material, that involves management or other employees who have a significant role in the registrant’s internal control over financial reporting.
|
Date:
|
November 6, 2020
|
By:
|
/s/ Juan J. Román-Jiménez
|
||
Juan J. Román-Jiménez
|
|||||
Executive Vice President and Chief Financial Officer
|
a) |
The Report fully complies with the requirements of section 13(a) or 15(d) of the Securities Exchange Act of 1934; and
|
b) |
The information contained in the Report fairly presents, in all material respects, the financial condition and results of operations of the Company.
|
Date:
|
November 6, 2020
|
By:
|
/s/ Roberto García-Rodríguez
|
||
Roberto García-Rodríguez
|
|||||
President and Chief Executive Officer
|
a) |
The Report fully complies with the requirements of section 13(a) or 15(d) of the Securities Exchange Act of 1934; and
|
b) |
The information contained in the Report fairly presents, in all material respects, the financial condition and results of operations of the Company.
|
Date:
|
November 6, 2020
|
By:
|
/s/ Juan J. Román-Jiménez
|
||
Juan J. Román-Jiménez
|
|||||
Executive Vice President and Chief Financial Officer
|
Condensed Consolidated Interim Balance Sheets (Unaudited) (Parenthetical) - Class B Common Stock [Member] - $ / shares |
Sep. 30, 2020 |
Dec. 31, 2019 |
---|---|---|
Triple-S Management Corporation stockholders' equity | ||
Common stock, par value (in dollars per share) | $ 1 | $ 1 |
Common stock, authorized (in shares) | 100,000,000 | 100,000,000 |
Common stock, issued (in shares) | 23,430,222 | 23,799,633 |
Common stock, outstanding (in shares) | 23,430,222 | 23,799,633 |
Condensed Consolidated Interim Statements of Earnings (Unaudited) - USD ($) $ in Thousands |
3 Months Ended | 9 Months Ended | ||
---|---|---|---|---|
Sep. 30, 2020 |
Sep. 30, 2019 |
Sep. 30, 2020 |
Sep. 30, 2019 |
|
Revenues: | ||||
Premiums, net | $ 922,934 | $ 815,021 | $ 2,657,366 | $ 2,442,516 |
Administrative service fees | 3,752 | 2,607 | 8,755 | 7,695 |
Net investment income | 14,168 | 15,176 | 42,294 | 45,614 |
Other operating revenues | 2,052 | 3,167 | 6,394 | 6,335 |
Total operating revenues | 942,906 | 835,971 | 2,714,809 | 2,502,160 |
Net realized investment gains (losses) | 507 | 1,087 | (180) | 4,766 |
Net unrealized investment gains (losses) on equity investments | 11,040 | 1,267 | (17,428) | 24,259 |
Other income, net | 1,811 | 485 | 6,217 | 3,359 |
Total revenues | 956,264 | 838,810 | 2,703,418 | 2,534,544 |
Benefits and expenses: | ||||
Claims incurred | 761,792 | 680,010 | 2,129,401 | 2,009,504 |
Operating expenses | 158,809 | 136,882 | 499,669 | 403,629 |
Total operating costs | 920,601 | 816,892 | 2,629,070 | 2,413,133 |
Interest expense | 2,096 | 2,062 | 5,813 | 5,681 |
Total benefits and expenses | 922,697 | 818,954 | 2,634,883 | 2,418,814 |
Income before taxes | 33,567 | 19,856 | 68,535 | 115,730 |
Income tax expense | 9,989 | 5,910 | 27,520 | 36,075 |
Net income | 23,578 | 13,946 | 41,015 | 79,655 |
Net loss attributable to non-controlling interest | (3) | (2) | (20) | (10) |
Net income attributable to Triple-S Management Corporation | $ 23,581 | $ 13,948 | $ 41,035 | $ 79,665 |
Earnings per share attributable to Triple-S Management Corporation | ||||
Basic net income per share (in dollars per share) | $ 1.02 | $ 0.59 | $ 1.77 | $ 3.44 |
Diluted net income per share (in dollars per share) | $ 1.02 | $ 0.58 | $ 1.76 | $ 3.43 |
Condensed Consolidated Interim Statements of Comprehensive Income (Loss) (Unaudited) - USD ($) $ in Thousands |
3 Months Ended | 9 Months Ended | ||
---|---|---|---|---|
Sep. 30, 2020 |
Sep. 30, 2019 |
Sep. 30, 2020 |
Sep. 30, 2019 |
|
Condensed Consolidated Interim Statements of Comprehensive Income (Loss) (Unaudited) [Abstract] | ||||
Net income | $ 23,578 | $ 13,946 | $ 41,015 | $ 79,655 |
Other comprehensive income, net of tax: | ||||
Net unrealized change in fair value of available for sale securities, net of taxes | 4,743 | 9,290 | 32,023 | 37,660 |
Defined benefit pension plan: | ||||
Actuarial loss, net | 247 | 61 | 553 | 173 |
Total other comprehensive income, net of tax | 4,990 | 9,351 | 32,576 | 37,833 |
Comprehensive income | 28,568 | 23,297 | 73,591 | 117,488 |
Comprehensive loss attributable to non-controlling interest | (3) | (2) | (20) | (10) |
Comprehensive income attributable to Triple-S Management Corporation | $ 28,571 | $ 23,299 | $ 73,611 | $ 117,498 |
Condensed Consolidated Interim Statements of Stockholders' Equity (Unaudited) - USD ($) $ in Thousands |
Common Stock [Member]
Class A Common Stock [Member]
|
Common Stock [Member]
Class B Common Stock [Member]
|
Additional Paid-in Capital [Member] |
Retained Earnings [Member] |
Accumulated Other Comprehensive Income [Member] |
Triple-S Management Corporation [Member] |
Noncontrolling Interest in Consolidated Subsidiary [Member] |
Total |
Cumulative Effect, Period of Adoption, Adjustment [Member]
Common Stock [Member]
Class A Common Stock [Member]
|
Cumulative Effect, Period of Adoption, Adjustment [Member]
Common Stock [Member]
Class B Common Stock [Member]
|
Cumulative Effect, Period of Adoption, Adjustment [Member]
Additional Paid-in Capital [Member]
|
Cumulative Effect, Period of Adoption, Adjustment [Member]
Retained Earnings [Member]
|
Cumulative Effect, Period of Adoption, Adjustment [Member]
Accumulated Other Comprehensive Income [Member]
|
Cumulative Effect, Period of Adoption, Adjustment [Member]
Triple-S Management Corporation [Member]
|
Cumulative Effect, Period of Adoption, Adjustment [Member]
Noncontrolling Interest in Consolidated Subsidiary [Member]
|
Cumulative Effect, Period of Adoption, Adjustment [Member] |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Balance at Dec. 31, 2018 | $ 951 | $ 21,980 | $ 34,021 | $ 761,970 | $ 3,062 | $ 821,984 | $ (676) | $ 821,308 | ||||||||
Increase (Decrease) in Stockholders' Equity [Roll Forward] | ||||||||||||||||
Share-based compensation | 0 | 177 | 1,409 | 0 | 0 | 1,586 | 0 | 1,586 | ||||||||
Repurchase and retirement of common stock | 0 | (1) | (15) | 0 | 0 | (16) | 0 | (16) | ||||||||
Comprehensive income (loss) | 0 | 0 | 0 | 34,786 | 13,497 | 48,283 | (3) | 48,280 | ||||||||
Balance at Mar. 31, 2019 | 951 | 22,156 | 35,415 | 796,756 | 16,559 | 871,837 | (679) | 871,158 | ||||||||
Increase (Decrease) in Stockholders' Equity [Roll Forward] | ||||||||||||||||
Share-based compensation | 0 | 44 | 4,276 | 0 | 0 | 4,320 | 0 | 4,320 | ||||||||
Comprehensive income (loss) | 0 | 0 | 0 | 30,931 | 14,985 | 45,916 | (5) | 45,911 | ||||||||
Balance at Jun. 30, 2019 | 951 | 22,200 | 39,691 | 827,687 | 31,544 | 922,073 | (684) | 921,389 | ||||||||
Increase (Decrease) in Stockholders' Equity [Roll Forward] | ||||||||||||||||
Share-based compensation | 0 | 1 | 2,816 | 0 | 0 | 2,817 | 0 | 2,817 | ||||||||
Issuance of Common Stock | 48 | 0 | 1,151 | 0 | 0 | 1,199 | 0 | 1,199 | ||||||||
Stock dividend | 0 | 1,133 | 23,522 | |||||||||||||
Stock dividend | (24,655) | 0 | 0 | 0 | 0 | |||||||||||
Dividend | 0 | 0 | 0 | (11) | 0 | (11) | 0 | (11) | ||||||||
Common Stock Class A conversion to Class B | (999) | |||||||||||||||
Common Stock Class A conversion to Class B | 999 | 0 | 0 | 0 | 0 | 0 | 0 | |||||||||
Comprehensive income (loss) | 0 | 0 | 0 | 13,948 | 9,351 | 23,299 | (2) | 23,297 | ||||||||
Balance at Sep. 30, 2019 | 0 | 24,333 | 67,180 | 816,969 | 40,895 | 949,377 | (686) | 948,691 | ||||||||
Balance at Dec. 31, 2019 | 0 | 23,800 | 60,504 | 830,198 | 29,363 | 943,865 | (693) | 943,172 | ||||||||
Balance (ASU 2016-13 [Member]) at Dec. 31, 2019 | $ 0 | $ 0 | $ 0 | $ (166) | $ 0 | $ (166) | $ 0 | $ (166) | ||||||||
Increase (Decrease) in Stockholders' Equity [Roll Forward] | ||||||||||||||||
Share-based compensation | 0 | 590 | 1,769 | 0 | 0 | 2,359 | 0 | 2,359 | ||||||||
Repurchase and retirement of common stock | 0 | (584) | (8,511) | 0 | 0 | (9,095) | 0 | (9,095) | ||||||||
Comprehensive income (loss) | 0 | 0 | 0 | (26,145) | 16,032 | (10,113) | (7) | (10,120) | ||||||||
Balance at Mar. 31, 2020 | 0 | 23,806 | 53,762 | 803,887 | 45,395 | 926,850 | (700) | 926,150 | ||||||||
Increase (Decrease) in Stockholders' Equity [Roll Forward] | ||||||||||||||||
Share-based compensation | 0 | 7 | 4,228 | 0 | 0 | 4,235 | 0 | 4,235 | ||||||||
Repurchase and retirement of common stock | 0 | (375) | (5,618) | 0 | 0 | (5,993) | 0 | (5,993) | ||||||||
Comprehensive income (loss) | 0 | 0 | 0 | 43,599 | 11,554 | 55,153 | (10) | 55,143 | ||||||||
Balance at Jun. 30, 2020 | 0 | 23,438 | 52,372 | 847,486 | 56,949 | 980,245 | (710) | 979,535 | ||||||||
Increase (Decrease) in Stockholders' Equity [Roll Forward] | ||||||||||||||||
Share-based compensation | 0 | 7 | 1,842 | 0 | 0 | 1,849 | 0 | 1,849 | ||||||||
Repurchase and retirement of common stock | 0 | (15) | (250) | 0 | 0 | (265) | 0 | (265) | ||||||||
Comprehensive income (loss) | 0 | 0 | 0 | 23,581 | 4,990 | 28,571 | (3) | 28,568 | ||||||||
Balance at Sep. 30, 2020 | $ 0 | $ 23,430 | $ 53,964 | $ 871,067 | $ 61,939 | $ 1,010,400 | $ (713) | $ 1,009,687 |
Basis of Presentation |
9 Months Ended | ||
---|---|---|---|
Sep. 30, 2020 | |||
Basis of Presentation [Abstract] | |||
Basis of Presentation |
The accompanying condensed consolidated interim financial statements prepared by Triple-S Management Corporation and its subsidiaries are unaudited. In this filing, the “Corporation”, the “Company”, “TSM”, “we”, “us” and “our” refer to Triple-S Management Corporation and its subsidiaries. The condensed consolidated interim financial statements do not include all of the information and the footnotes required by accounting principles generally accepted in the United States of America (GAAP or U.S. GAAP) for complete financial statement presentation pursuant to the rules and regulations of the Securities and Exchange Commission (SEC). Accordingly, these condensed consolidated interim financial statements should be read in conjunction with the audited consolidated financial statements included in the Company’s Annual Report on Form 10-K for the year ended December 31, 2019.
In the opinion of management, all adjustments, consisting of a normal recurring nature necessary for a fair presentation of such condensed consolidated interim financial statements, have been included. The results of operations for the three months and nine months ended September 30, 2020 are not necessarily indicative of the results for the full year ending December 31, 2020.
|
Significant Accounting Policies |
9 Months Ended | ||
---|---|---|---|
Sep. 30, 2020 | |||
Significant Accounting Policies [Abstract] | |||
Significant Accounting Policies |
Investments
Fixed maturities
Investment in debt securities at September 30, 2020 and December 31, 2019 consists mainly of obligations of government-sponsored enterprises, U.S. Treasury securities and obligations of U.S. government instrumentalities, municipal securities, corporate bonds, residential mortgage-backed securities, and collateralized mortgage obligations. The Company classifies its debt securities in one of two categories: available-for-sale or held-to-maturity. Securities classified as held-to-maturity are those securities in which the Company has the ability and intent to hold until maturity. All other securities not included in held-to-maturity are classified as available-for-sale.
Available-for-sale securities are recorded at fair value. The fair values of debt securities (both available-for-sale and held-to-maturity investments) are based on quoted market prices for those or similar investments at the reporting date. Held-to-maturity debt securities are recorded at amortized cost, adjusted for the amortization or accretion of premiums and discounts, respectively. Unrealized holding gains and losses, net of the related tax effect, on available-for-sale securities are excluded from earnings and are reported as a separate component of other comprehensive income until realized. Realized gains and losses from the sale of available-for-sale securities are included in earnings and are determined on a specific identification basis.
Transfers of securities between categories are recorded at fair value at the date of transfer. Unrealized holding gains or losses associated with transfers of securities from held-to-maturity to available-for-sale are recorded as a separate component of other comprehensive income. The unrealized holding gains or losses included in the separate component of other comprehensive income for securities transferred from available-for-sale to held-to-maturity, are maintained and amortized into earnings over the remaining life of the security as an adjustment to yield in a manner consistent with the amortization or accretion of premium or discount on the associated security.
If a fixed maturity security is in an unrealized loss position and the Company does not have the intent to sell the fixed maturity security, or it is more likely than not that the Company will not have to sell the fixed maturity security before recovery of its amortized cost basis, the credit component of the impairment, if any, is recorded as an allowance for credit losses with an offsetting entry in the Company’s consolidated statements of earnings. The non-credit component of the impairment is recognized in other comprehensive income. Furthermore, unrealized losses entirely caused by non-credit related factors related to fixed maturity securities for which the Company expects to fully recover the amortized cost basis continue to be recognized in accumulated other comprehensive income.
If a fixed maturity security is in an unrealized loss position and the Company has the intent to sell the fixed maturity security, or it is more likely than not that the Company will have to sell the fixed maturity security before recovery of its amortized cost basis, the Company will write off any previously recognized allowance for credit losses and will decrease the amortized cost basis of the security. If the allowance has been fully written off and the fair value is less than its amortized cost basis, the amortized cost basis is written down and an impairment loss is recognized in the Company’s consolidated statements of earnings. As of September 30, 2020, no allowance for credit losses was recorded in the condensed consolidated interim financial statements.
The credit component of the impairment is determined by comparing the net present value of projected future cash flows with the amortized cost basis of the fixed maturity security. The net present value is calculated by discounting the Company’s best estimate of projected future cash flows at the effective interest rate implicit in the fixed maturity security at the date of acquisition. If there is an increase in the projected future cash flows of the fixed maturity security in subsequent periods, all or part of the allowance for credit losses may be reversed.
In addition, the Company considers the following factors when evaluating whether a credit loss exist: the reasons for the impairment, the severity of the impairment, market conditions, changes in the security’s rating, changes in value subsequent to year-end, forecasted performance of the investee, and the general market condition in the geographic area or industry the investee operates in.
Premiums and discounts are amortized or accreted over the life of the related held-to-maturity or available-for-sale security as an adjustment to yield using the effective interest method. Dividend and interest income are recognized when earned.
The Company regularly invests in mortgaged-backed securities and other securities subject to prepayment and call risk. Significant changes in prevailing interest rates may adversely affect the timing and amount of cash flows on such securities. In addition, the amortization of market premium and accretion of market discount for mortgaged-backed securities is based on historical experience and estimates of future payment speeds on the underlying mortgage loans. Actual prepayment speeds may differ from original estimates and may result in material adjustments to amortization or accretion recorded in future periods.
Equity investments
Investment in equity securities at September 30, 2020 and December 31, 2019 consists of mutual funds whose underlying assets are comprised of domestic equity securities, international equity securities and higher risk fixed income instruments. Equity investments are recorded at fair value. The fair values of equity investments are mainly based on quoted market prices for those or similar investments at the reporting date. For a specific equity investment, the fair value is estimated using the net asset value (NAV) of the Company’s ownership interest in the partnership. Unrealized holding gains and losses on equity investments are included in earnings. Realized gains and losses from the sale of equity investments are included in earnings and are determined on a specific identification basis.
Other invested assets
Other invested assets at September 30, 2020 and December 31, 2019 consist mainly of alternative investments in partnerships that invest in several private debt and private equity funds. Portfolios are diversified by vintage year, stage, geography, business sectors and number of investments. These investments are not redeemable with the funds. Distributions from each fund are received as the underlying investments of the funds are liquidated. It is estimated that the underlying assets of the funds will be liquidated in the next 5 to 12 years. The fair value of the investments in this class have been estimated using the net asset value (NAV) of the Company’s ownership interest in the partnerships. Total unfunded capital commitments for these positions as of September 30, 2020 amounted to $57,762. The remaining average commitments period is approximately three years.
Health Insurance Providers Fee
The Patient Protection and Affordable Care Act (ACA) as amended by the Health Care and Education Reconciliation Act mandates an annual Health Insurance Providers Fee (HIP Fee). The annual HIP Fee becomes payable to the U.S. Treasury once the entity provides health insurance for any U.S. health risk each applicable calendar year. The initial estimated annual fee is accrued as of January 1, with a corresponding deferred cost that is amortized over 12 months on a straight-line basis. The fee payment is due on September 30 of each year. The deferred cost is included within the other asset line item and the accrued fee is included within the accounts payable and accrued liabilities line item in the accompanying condensed consolidated balance sheets. The fee is presented within operating expenses in the accompanying condensed consolidated statements of earnings. The HIP Fee was waived for all health insurance providers during the year ended December 31, 2019. The Taxpayer Certainty and Disaster Tax Relief Act of 2019 and the Further Consolidated Appropriations Act of 2020, signed into law on December 20, 2019, repealed the HIP Fee effective calendar years beginning after December 31, 2020. As of September 30, 2020, the HIP Fee deferred cost amounted to $12,139. During the quarter ended September 30, 2020, the Company made the corresponding payment amounting to $55,514. As of December 31, 2019, no balance was deferred or accrued for the HIP Fee.
Recently Adopted Accounting Standards
On June 16, 2016, the Financial Accounting Standards Board (FASB) issued guidance to provide financial statement users with more decision-useful information about the expected credit losses on financial instruments and other commitments to extend credit held by a reporting entity at each reporting date by replacing the incurred loss impairment methodology in current U.S. GAAP with a methodology that reflects expected credit losses and requires consideration of a broader range of reasonable and supportable information to inform credit loss estimates. In addition, on April 25, 2019, the FASB issued Accounting Standard Update (ASU) 2019-04: Codification Improvements to Topic 326, Financial Instruments – Credit Losses, Topic 815, Derivatives and Hedging, and Topic 825, Financial Instruments. The amendments in this update represent changes to clarify, correct errors in or improve the codification. Such amendments should make the codification easier to understand and easier to apply by eliminating inconsistencies and providing clarifications. Within the clarifications was the FASB’s intent to include all reinsurance recoverables within the scope of ASU 2016-13 (Topic 326). For public companies, the improvements related to ASU 2016-13 (Topic 326) and ASU 2016-01 (Topic 825) are effective for fiscal years beginning after December 15, 2019, including interim periods within those fiscal years. The Company adopted the standard effective January 1, 2020 and recognized $166, net of deferred tax asset, as a cumulative effect adjustment to the opening balance of retained earnings on the adoption date.
On January 26, 2017, the FASB issued guidance to simplify the manner in which an entity is required to evaluate goodwill for impairment by eliminating Step 2 from the goodwill impairment test. Step 2 measures a goodwill impairment loss by comparing the implied fair value of a reporting unit’s goodwill with the carrying amount of that goodwill. Instead, under the amendments in this guidance, an entity should (1) perform its annual or interim goodwill impairment test by comparing the fair value of a reporting unit with its carrying amount, and (2) recognize an impairment charge for the amount by which the carrying amount exceeds the reporting unit’s fair value, with the understanding that the loss recognized should not exceed the total amount of goodwill allocated to that reporting unit. Additionally, this guidance removes the requirements for any reporting unit with a zero or negative carrying amount to perform a qualitative assessment and, if it fails such qualitative test, to perform Step 2 of the goodwill impairment test. For public companies, these amendments, which should be applied on a prospective basis, are effective for fiscal years beginning after December 15, 2019, including interim periods within those fiscal years. The Company adopted the standard effective January 1, 2020. Upon adoption of this standard, if the carrying amount of any of the reporting units exceeds its fair value, the Company will be required to record an impairment charge for the difference up to the amount of the goodwill.
On August 27, 2018, the FASB issued guidance for Fair Value Measurement – Disclosure Framework – Changes to the Disclosure Requirement for Fair Value Measurement. This update focuses on improving the effectiveness of disclosures in the notes to the financial statements by facilitating clear communication of the information required by U.S. GAAP that is most important to users of each entity’s financial statements. Specifically, certain disclosure requirements are removed (the amount of, and reasons for, transfer between Level 1 and Level 2 of the fair value hierarchy; the policy for timing of transfers between levels; the valuation processes for Level 3 fair value measurements) while certain other disclosures are modified and added (changes in unrealized gains and losses for the period included in other comprehensive income for recurring Level 3 fair value measurements held at the end of the reporting period, and the range and weighted average of significant unobservable inputs used to develop Level 3 fair value measurements). The amendments regarding changes in unrealized gains and losses, the range and weighted average of significant unobservable inputs used to develop Level 3 fair value measurements, and the narrative description of measurement uncertainty should be applied prospectively for only the most recent period in the initial fiscal year of adoption. All other amendments should be applied retrospectively to all periods presented upon their effective date. For public companies, these amendments will be applied for fiscal years beginning after December 15, 2019, including interim periods within those fiscal years. The Company adopted the standard effective January 1, 2020. The adoption of this guidance did not have a material impact on the presentation and disclosures of the Company’s condensed consolidated interim financial statements.
On August 29, 2018, the FASB issued guidance for Intangibles – Goodwill and Other – Internal-Use Software. Guidance addresses customers’ accounting for implemented costs incurred in a cloud computing arrangement that is a service contract and aims to reduce complexity in the accounting for costs of implementing a cloud computing service arrangement. The amendments require a customer in a hosting arrangement that is a service contract to determine which implementation costs to capitalize as an asset related to the service contract and which costs to expense. Additionally, it requires the customer to expense the capitalized implementation costs over the term of the hosting arrangement. For public companies, these amendments will be applied on a prospective basis, for fiscal years beginning after December 15, 2019, including interim periods within those fiscal years. The Company adopted the standard effective January 1, 2020. The adoption of this guidance did not have a material impact on the results of the Company’s condensed consolidated interim financial statements.
Future Adoption of Accounting Standards
On March 12, 2020, the FASB issued ASU 2020-04: Reference Rate Reform (Topic 848): Facilitation of the Effects of Reference Rate Reform on Financial Reporting. The ASU was issued to provide optional guidance, for a limited time, to ease the potential burden in accounting for or recognizing the effects of reference rate reform on financial reporting. The amendments, which are elective and apply to all entities, provide expedients and exceptions for applying U.S. GAAP to contract modifications and hedging relationships affected by reference rate reform if certain criteria are met. The amendments apply only to contracts and hedging relationships that reference LIBOR or another reference rate that is expected to be discontinued due to reference rate reform. Because the guidance is intended to assist stakeholders during the global market-wide reference rate transition period, it is in effect for a limited time, from March 12, 2020 through December 31, 2022. The Company is currently in the process of identifying its LIBOR-based contracts that will be impacted by the phase-out of LIBOR and expects to utilize the optional expedients provided in this ASU.
Other than the accounting pronouncements disclosed above, there were no other new accounting pronouncements issued during the three months and nine months ended September 30, 2020 that could have a material impact on the Company’s financial position, operating results or financials statement disclosures.
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Investment in Securities |
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Investment in Securities [Abstract] | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Investment in Securities |
The amortized cost for debt securities and cost for alternative investments, gross unrealized gains, gross unrealized losses, and estimated fair value for the Company’s investments in securities by major security type and class of security at September 30, 2020 and December 31, 2019, were as follows:
Gross unrealized losses on investment securities and the estimated fair value of the related securities, aggregated by investment category and length of time that individual securities have been in a continuous unrealized loss position as of September 30, 2020 and December 31, 2019 were as follows:
The Company reviews the available for sale and other invested assets portfolios under the Company’s impairment review policy. Given market conditions and the significant judgments involved, there is a continuing risk that declines in fair value may occur and material impairments and allowances may be recorded in future periods. The Corporation from time to time may sell investments as part of its asset/liability management process or to reposition its investment portfolio based on current and expected market conditions.
Obligations of Government-Sponsored Enterprises and Municipal Securities: The unrealized losses of these securities were mainly caused by fluctuations in interest rates and general market conditions. The contractual terms of these investments do not permit the issuer to settle the securities at a price less than the par value of the investment. In addition, these investments have investment grade ratings. The Company does not consider these investments to be credit impaired because the decline in fair value is attributable to changes in interest rates and not credit quality; the Company does not intend to sell the investments and it is not more likely than not that the Company will be required to sell the investments before recovery of their amortized cost basis, which may be maturity; and because the Company expects to collect all contractual cash flows.
Residential mortgage-backed securities and Collateral mortgage obligations: The unrealized losses on these investments were mostly caused by fluctuations in interest rates and credit spreads. The contractual cash flows of these securities are guaranteed by a U.S. government-sponsored enterprise. Any loss in these securities is determined according to the seniority level of each tranche, with the least senior (or most junior), typically the unrated residual tranche, taking any initial loss. The investment grade credit rating of our securities reflects the seniority of the securities that the Company owns. The Company does not consider these investments to be credit impaired because the decline in fair value is attributable to changes in interest rates; the Company does not intend to sell the investments and it is more likely than not that the Company will not be required to sell the investments before recovery of their amortized cost basis, which may be maturity; and because the Company expects to collect all contractual cash flows.
Alternative investments: As of September 30, 2020, alternative investments with unrealized losses are not considered credit impaired based on market conditions.
Maturities of investment securities classified as available for sale and held to maturity were as follows:
Expected maturities may differ from contractual maturities because some issuers have the right to call or prepay obligations with or without call or prepayment penalties.
Investments with an amortized cost of $232,818 and $145,981 and a fair value of $252,601 and $152,916 at September 30, 2020 and December 31, 2019, respectively, were pledged with the Federal Home Loan Bank of New York (FHLBNY) to secure short-term borrowings.
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Realized and Unrealized Gains (Losses) |
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Realized and Unrealized Gains (Losses) |
Information regarding realized and unrealized gains and losses from investments is as follows:
The gross losses from impaired securities during the nine months ended September 30, 2020 is related to an equity method investment held by the Company.
The change in deferred tax liability on unrealized gains recognized in accumulated other comprehensive income during the nine months ended September 30, 2020 and 2019 was $8,446 and $9,892, respectively.
As of September 30, 2020, and December 31, 2019, no individual investment in securities exceeded 10% of stockholders’ equity.
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Premiums and Other Receivables, Net |
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Premiums and Other Receivables, Net |
Premiums and other receivables, net were as follows:
As of September 30, 2020, and December 31, 2019, the Company had premiums and other receivables of $71,322 and $49,176, respectively, from the Government of Puerto Rico, including its agencies, municipalities and public corporations. The related allowance for doubtful receivables as of September 30, 2020 and December 31, 2019 were $24,268 and $22,091, respectively.
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Property and Equipment, Net |
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Property and Equipment, Net |
Property and equipment, net are composed of the following:
On June 19, 2020, the Company acquired a nine-story office building (the Building), located at 1451 F.D. Roosevelt Avenue, in San Juan, Puerto Rico, as well as the adjoining multi-level parking structure and a parking lot. See Note 9 for further information on the credit agreement obtained to partially finance the acquisition of the Building.
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Fair Value Measurements |
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Fair Value Measurements [Abstract] | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Fair Value Measurements |
Our condensed consolidated balance sheets include the following financial instruments: securities available for sale, equity investments, policy loans, policyholder deposits, short-term borrowings and long-term borrowings. We consider the carrying amounts of policy loans, policyholder deposits, short-term borrowings and long-term borrowings to approximate their fair value and are considered Level 2 financial instruments. Certain assets are measured at fair value on a recurring basis and are disclosed below. These assets are classified into one of three levels of a hierarchy defined by GAAP. For a description of the methods and assumptions that are used to estimate the fair value and determine the fair value hierarchy classification of each class of financial instrument, see the consolidated financial statements and notes thereto included in our 2019 Annual Report on Form 10-K.
The following tables summarize fair value measurements by level for assets measured at fair value on a recurring basis:
There were no transfers between Levels 1 and 2 during the three and nine months ended September 30, 2020 and the year ended December 31, 2019.
A reconciliation of the beginning and ending balances of assets measured at fair value on a recurring basis using significant unobservable inputs (Level 3) for the three months and nine months ended September 30 is as follows:
The fair value of investment securities is estimated based on quoted market prices for those or similar investments. Additional information pertinent to the estimated fair value of investment in securities is included in Note 3.
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Claim Liabilities |
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Claim Liabilities |
A reconciliation of the beginning and ending balances of claim liabilities is as follows:
* Other Business Segments include the Life Insurance and Property and Casualty segments, as well as intersegment eliminations.
* Other Business Segments include the Life Insurance and Property and Casualty segments, as well as intersegment eliminations.
The actual amounts of claims incurred in connection with insured events occurring in a prior period typically differ from estimates of such claims made in the prior period. Amounts included as incurred claims for prior period insured events reflect the aggregate net amount of these differences.
The unfavorable prior period development in the claims incurred and loss-adjustment expenses for prior period insured events for the nine months ended September 30, 2020 are due primarily to higher than expected utilization trends in the Managed Care segment. The favorable development in the claims incurred and loss-adjustment expenses for prior period insured events for the nine months ended September 30, 2019 are due primarily to better than expected utilization trends. Reinsurance recoverable on unpaid claims is reported as premiums and other receivables, net in the accompanying condensed consolidated interim financial statements.
The claims incurred disclosed in this table exclude the portion of the change in the liability for future policy benefits expense, which amounted to $27,806 and $26,211 during the nine months ended September 30, 2020 and 2019, respectively.
The following is information about total incurred but not reported (IBNR) liabilities plus expected development on reported claims included in the liability for unpaid claims adjustment expenses for the Managed Care segment as of September 30, 2020.
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Borrowings |
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Borrowings [Abstract] | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Borrowings |
Long-Term Borrowings
A summary of the borrowings entered by the Company are as follows:
Aggregate maturities of the Company’s borrowings as of September 30, 2020 are summarized as follows:
On June 19, 2020, TSM entered into a $31,350 Credit Agreement (the Loan) with a commercial bank in Puerto Rico. The proceeds of the Loan were used by the Company to partially finance the acquisition of the Building (see Note 6).
The Loan is guaranteed by a mortgage over the Building, a pledge of all collateral related to the Building and an assignment of the rents collected for the lease of office space in the Building. Pursuant to the credit agreement, interest is payable on the outstanding principal balance of the Loan at an annual rate equal to the Prime Rate. Interest shall be paid on a monthly basis commencing on July 1, 2020 until the principal of the Loan has been paid in full.
The Company may, at its option and at any time, upon written notice as specified in the credit agreement, prepay prior to maturity, all or any part of the Loan upon the payment of a penalty fee of the outstanding principal amount at the time of the prepayment of 3% during the first year, 2% during the second year and 1% during the third year, and thereafter at par.
The four term loans under credit agreements with commercial banks in Puerto Rico include certain customary financial and non-financial covenants, including negative covenants imposing certain restrictions on the Corporation’s business. The Company was in compliance with all these covenants as of September 30, 2020.
Short-term Borrowings
The Company has several short-term facilities available to address timing differences between cash receipts and disbursements, consisting of collateralized advances from FHLBNY and a revolving credit facility.
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Pension Plan |
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Pension Plan |
The components of net periodic benefit cost were as follows:
Employer Contributions: The Company disclosed in its audited consolidated financial statements for the year ended December 31, 2019 that it expected to contribute $2,000 to the pension program in 2020. As of September 30, 2020, the Company has contributed $10,000 to the pension program.
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Stock Repurchase Programs |
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Stock Repurchase Programs [Abstract] | |||
Stock Repurchase Programs |
The Company repurchases shares through open market transactions, in accordance with Rule 10b-18 of the Securities Exchange Act of 1934, as amended, under repurchase programs authorized by the Board of Directors. Shares purchased under share repurchase programs are retired and returned to authorized and unissued status.
In August 2017 the Company’s Board of Directors authorized a $30,000 repurchase program (2017 $30,000 program) of its Class B common stock. In February 2018 the Company’s Board of Directors authorized a $25,000 expansion of this program. In October 2019 the Company’s Board of Directors authorized an expansion to this repurchase program increasing its remaining balance up to a total of $25,000, effective November 2019.
During the three months ended September 30, 2020, no stocks were repurchased under a repurchase program. During the nine months ended September 30, 2020, the Company repurchased and retired under this program 952,820 shares at an average per share price of $15.72, for an aggregate cost of $14,982. During the three months and nine months ended September 30, 2019 no stocks were repurchased under a repurchase program. This program was completed in May 2020.
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Reinsurance |
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Reinsurance [Abstract] | |||||||||||
Reinsurance |
Triple-S Propiedad, Inc. (TSP) uses facultative reinsurance, pro rata, and excess of loss reinsurance treaties to manage its exposure to losses, including those from catastrophe events. TSP has geographic exposure to catastrophe losses from hurricanes and earthquakes. The incidence and severity of catastrophes are inherently unpredictable.
Under these treaties, TSP ceded premiums written were $14,920 and $12,355 for the three months ended September 30, 2020 and 2019, respectively, and $45,637 and $36,028 for the nine months ended September 30, 2020, and 2019, respectively. Ceded incurred losses and loss adjustment expenses during the three months and nine months ended September 30, 2020 and 2019 were $5,419 and $1,089, respectively, and $45,802 and $6,531, respectively. The ceded incurred losses and loss adjustment expenses for the nine months ended September 30, 2020 include $40,000 related to earthquake losses ceded under catastrophe reinsurance.
Principal reinsurance agreements are as follows:
All principal reinsurance contracts are for a period of one year and are subject to modifications and negotiations in each renewal. TSP’s current property and catastrophe reinsurance program was renewed effective April 1, 2020 for a twelve months period ending March 31, 2021. Other contracts were renewed as expiring on January 1, 2020.
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Leases |
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Leases [Abstract] | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Leases |
The Company’s subsidiaries lease their regional offices, certain equipment, and warehouse facilities under non-cancelable operating leases. These contracts generally do not include purchase options or residual value guarantees. The remaining lease terms ranges from 0.2 to 14.2 years. The Company identifies leases when it has both the right to obtain substantially all economic benefits from the use of the asset and the right to direct the use of the asset.
The Company recognizes the right-of -use of assets and lease liabilities related to operating leases in its balance sheet statement under the caption of
and , respectively. As of September 30, 2020, the right -of -use asset and lease liabilities balance was $13,929 and $14,171, respectively. As of December 31, 2019, the right-of -use asset and lease liabilities balance was $10,438 and $10,586, respectively. The weighted -average remaining lease term is 5.9 years as of September 30, 2020.The Company uses the incremental borrowing rate for purposes of discounting lease payments for our operating leases since our lease agreements do not provide a readily determinable implicit rate. We estimate our incremental borrowing rate by using an interest rate index and add a credit spread to this rate based on financing transactions with a similar credit risk profile. The weighted-average discount rate of our operating leases is 5.2% as of September 30, 2020.
Undiscounted cash flows of operating leases are summarized as follows:
At December 31, 2019, operating lease commitments under lessee arrangements were $4,713, $3,790, $3,200, $2,171, $1,710 and $2,707 for 2020 through 2024 and thereafter, respectively. The following presents the lease cost recognized by the Company:
Also, the Company leases certain floors of one of its buildings and generates rental income. Maturity analysis of lease payments to be received from its lessees as of September 30, 2020, is summarized as follows:
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Comprehensive Income (Loss) |
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Comprehensive Income (Loss) [Abstract] | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Comprehensive Income (Loss) |
The accumulated balances for each classification of other comprehensive income (loss), net of tax, are as follows:
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Share-Based Compensation |
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Share-Based Compensation [Abstract] | |||
Share-Based Compensation |
Share-based compensation expense recorded during the three months ended September 30, 2020 and 2019 was $1,849 and $2,817, respectively. Share-based compensation expense recorded during the nine months ended September 30, 2020 and 2019 was $8,443 and $8,723, respectively. During the three months ended September 30, 2020, 14,040 shares were repurchased and retired as the result of non-cash tax withholdings upon vesting of shares. During the nine months ended September 30, 2020 and 2019, 20,922 and 602 shares, respectively, were repurchased and retired as the result of non-cash tax withholdings upon vesting of shares. There were no non-cash tax withholdings during the three months ended September 30, 2019.
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Net Income Available to Stockholders and Net Income per Share |
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Net Income Available to Stockholders and Net Income per Share [Abstract] | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Net Income Available to Stockholders and Net Income per Share |
The following table sets forth the computation of basic and diluted earnings per share:
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Contingencies |
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Sep. 30, 2020 | |
Contingencies [Abstract] | |
Contingencies |
(17) Contingencies
The following information supplements and amends, as applicable, the disclosures in Note 24 to the Consolidated Financial Statements of the Company’s 2019 Annual Report on Form 10-K. The Company’s business is subject to numerous laws and regulations promulgated by Federal, Puerto Rico, U.S. Virgin Islands (USVI), Costa Rica, British Virgin Islands (BVI), and Anguilla governmental authorities. Compliance with these laws and regulations can be subject to government review and interpretation, as well as regulatory actions unknown and unasserted at this time. The Commissioner of Insurance of Puerto Rico, as well as other Federal, Puerto Rico, USVI, Costa Rica, BVI, and Anguilla government authorities, regularly make inquiries and conduct audits concerning the Company’s compliance with such laws and regulations. Penalties associated with violations of these laws and regulations may include significant fines and exclusion from participating in certain publicly funded programs and may require the Company to comply with corrective action plans or changes in our practices.
The Company is involved in various legal actions arising in the ordinary course of business. The Company is also defendant in various other litigations and proceedings, some of which are described below. Where the Company believes that a loss is both probable and estimable, such amounts have been recorded. Although the Company believes the estimates of such losses are reasonable, these estimates could change as a result of further developments in these matters. In other cases, it is at least reasonably possible that the Company may incur a loss related to one or more of the mentioned pending lawsuits or investigations, but the Company is unable to estimate the range of possible loss which may be ultimately realized, either individually or in the aggregate, upon their resolution. However, there are legal proceedings where a loss is reasonably possible, and for which it is possible to reasonably estimate the amount of the possible loss or range of losses. We currently believe that the range of possible losses for such proceedings in excess of established reserves is, in the aggregate, from $0 to approximately $10,000 at September 30, 2020. The outcome of legal proceedings is inherently uncertain; pending matters for which accruals have not been established have not progressed sufficiently to enable us to estimate a range of possible loss, if any. Given the inherent unpredictability of these matters, it is possible that an adverse outcome in one or more of these matters could have a material effect on the consolidated financial condition, operating results and/or cash flows of the Company.
Additionally, we may face various potential litigation claims that have not been asserted to date.
Claims by Heirs of Former Shareholders
The Company and TSS are defending four individual lawsuits: Vera Sanchez, et al, v. Triple-S; Olivella Zalduondo, et al, v. Seguros de Servicios de Salud, et al; Cebollero Santamaria v. Triple-S Salud, Inc., et al; and Ruiz de Porras, et al, v. Triple-S Salud, Inc. All claims were filed in the Puerto Rico Court of First Instance by persons who claim to have inherited a total of 41 shares of the Company or one of its predecessors or affiliates (before giving effect to a 3,000-for-one stock split). While each case presents unique facts and allegations, the lawsuits generally allege that the redemption of the shares by the Company pursuant to transfer and ownership restrictions contained in the Company’s (or its predecessors’ or affiliates’) articles of incorporation and bylaws was improper. Consequently, the remedy requested by the plaintiffs is to be recognized as shareholders of the Company in the corresponding proportion.
As a result of the Puerto Rico Supreme Court’s decision to deny the applicability of the statute of limitations contained in the local securities law, these claims are being litigated on their merits.
In Cebollero Santamaria v. Triple-S Salud, Inc., et. al. the Puerto Rico Court of First Instance entered partial summary judgment in favor of plaintiff on June 20, 2019. The Company filed a request for reconsideration that is pending adjudication and intends to continue defending this case vigorously in an appeal stage if necessary.
In Vera Sanchez, et. al. v. Triple-S, Inc., the Puerto Rico Court of First Instance entered summary judgment in favor of the Company. Plaintiffs appealed before the Puerto Rico Court of Appeals. The Company filed its opposition on October 31, 2019. On June 24, 2020, the Court of Appeals revoked the summary judgement and remanded the case back to the Court of First Instance on the grounds that summary judgement was inappropriate because there are disputes as to issues of material fact. We will continue to defend this case vigorously.
In Ruiz de Porras, et. al. v. Triple-S, Inc. the Company intends to file a motion for summary judgment to dismiss all claims once new discovery matters are completed.
In Olivella Zalduondo, et al, v. Seguros de Servicios de Salud, et al, the Court of First Instance entered summary judgment in favor of the Company in November 2019, dismissing the complaint with prejudice. Plaintiffs appealed the decision on January 16, 2020. The Company will continue to defend this case as needed.
In re Blue Cross Blue Shield Antitrust Litigation
TSS is a co-defendant with multiple Blue Plans and the Blue Cross Blue Shield Association in a multi-district class action litigation filed by a group of providers and subscribers on July 24, 2012 and October 1, 2012, respectively, that has since been consolidated by the United States District Court for the Northern District of Alabama, Southern Division, in the case captioned In re Blue Cross Blue Shield Association Antitrust Litigation. Essentially, provider plaintiffs allege that the exclusive service area requirements of the Primary License Agreements with the Blue Plans constitute an illegal horizontal market allocation under federal antitrust laws. As per provider plaintiffs, the quid pro quo for said “market allocation” is a horizontal price fixing and boycott conspiracy implemented through BCBSA and whose benefits are allegedly derived through the BCBSA’s BlueCard/National Accounts Program. Among the remedies sought, provider plaintiffs seek increased compensation rates and operational changes. In turn, subscriber plaintiffs allege that the alleged conspiracy to allocate markets have prevented subscribers from being offered competitive prices and resulted in higher premiums for Blue Plan subscribers. Subscribers seek damages for the amounts that the Blue Plan premiums allegedly have been artificially inflated as a result of the alleged antitrust violations. Both actions seek injunctive relief.
Prior to consolidation, motions to dismiss were filed by several plans, including TSS - whose request was ultimately denied by the court without prejudice. On April 6, 2015, plaintiffs filed suit in the United States District Court of Puerto Rico against TSS. Said complaint, nonetheless, is believed not to preclude TSS’ jurisdictional arguments. Since inception, the Company has joined BCBSA and other Blue Plans in vigorously contesting these claims. On April 5, 2018, the United States District Court for the Northern District of Alabama, Southern Division, issued it’s ruling on the parties’ respective motions for partial summary judgment on the standard of review applicable to plaintiffs’ claims under Section 1 of the Sherman Act and subscriber plaintiffs’ motion for partial summary judgment on the Blue Plan’s single entity defense. After considering the “undisputed” facts (for summary judgment purposes only) and evidence currently on record in the light most favorable to defendants, the court essentially found that: (a) the combination of Exclusive Service Areas and the National Best Efforts Rule are subject to the Per Se standard of review; (b) there remain genuine issues of material fact as to whether defendants’ conduct can be shielded by the “single entity” defense; and (c) claims concerning the BlueCard Program and uncoupling rules are due to be analyzed under the Rule of Reason standard.
On April 16, 2018 Defendants moved the Federal District Court for the Northern District of Alabama to certify for immediate interlocutory appeal the court’s April 5, 2018 Standard of Review Ruling. On June 12, 2018 Hon. Judge Proctor agreed to grant Defendant’s motion for certification pursuant to 28 U.S.C. §1292(b). Defendants filed their Notice of Appeal on July 12, 2018. On December 12, 2018, the Court of Appeals for the Eleventh Circuit denied Defendants’ petition to appeal the District Court’s Standard of Review Ruling. The parties re-commenced mediation with subscribers in April 2019 and with providers in September 2019. The Defendants have reached a tentative settlement agreement with subscribers. The agreement remains subject to approval from the Federal District Court for the Northern District of Alabama. However, based on this agreement, the Company has accrued $32,000 related to this legal proceeding during the nine months ended September 30, 2020.
Claims Relating to the Provision of Health Care Services
TSS is a defendant in several claims for collection of monies in connection with the provision of health care services.
On January 12, 2015, American Clinical Solutions LLC, a limited liability company that provides clinical laboratory services filed a complaint in Florida state court alleging that TSM and TSS failed to pay certain clinical laboratory services provided to Blue Cross Blue Shield members. TSS and TSM have filed a motion to dismiss alleging lack of jurisdiction. TSM and TSS also requested a transfer of the case to Puerto Rico. Plaintiff has requested jurisdictional discovery, which is ongoing. The claim amounts to $5,000. TSS and TSM will continue to vigorously oppose this claim.
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Segment Information |
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Segment Information |
The Company’s operations are conducted principally through three business segments: Managed Care, Life Insurance, and Property and Casualty Insurance. The Company evaluates performance based primarily on the operating revenues and operating income of each segment. Operating revenues include premiums earned, net, administrative service fees, net investment income, and revenues derived from other segments. Operating costs include claims incurred and operating expenses. The Corporation calculates operating income or loss as operating revenues less operating costs.
The following tables summarize the operations by reportable segment for the three months and nine months ended September 30, 2020 and 2019:
* Includes segments that are not required to be reported separately, primarily the health clinics.
* Includes segments that are not required to be reported separately, primarily the health clinics.
* Includes segments that are not required to be reported separately, primarily the health clinics.
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Subsequent Events |
9 Months Ended | ||
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Sep. 30, 2020 | |||
Subsequent Events [Abstract] | |||
Subsequent Events |
The Company evaluated subsequent events through the date the unaudited condensed consolidated interim financial statements were issued. No events, other than those described in these notes, have occurred that require adjustment or disclosure pursuant to current Accounting Standard Codification.
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Basis of Presentation (Policies) |
9 Months Ended |
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Sep. 30, 2020 | |
Basis of Presentation [Abstract] | |
Basis of Presentation |
The accompanying condensed consolidated interim financial statements prepared by Triple-S Management Corporation and its subsidiaries are unaudited. In this filing, the “Corporation”, the “Company”, “TSM”, “we”, “us” and “our” refer to Triple-S Management Corporation and its subsidiaries. The condensed consolidated interim financial statements do not include all of the information and the footnotes required by accounting principles generally accepted in the United States of America (GAAP or U.S. GAAP) for complete financial statement presentation pursuant to the rules and regulations of the Securities and Exchange Commission (SEC). Accordingly, these condensed consolidated interim financial statements should be read in conjunction with the audited consolidated financial statements included in the Company’s Annual Report on Form 10-K for the year ended December 31, 2019.
In the opinion of management, all adjustments, consisting of a normal recurring nature necessary for a fair presentation of such condensed consolidated interim financial statements, have been included. The results of operations for the three months and nine months ended September 30, 2020 are not necessarily indicative of the results for the full year ending December 31, 2020.
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Significant Accounting Policies (Policies) |
9 Months Ended |
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Sep. 30, 2020 | |
Significant Accounting Policies [Abstract] | |
Investments |
Investments
Fixed maturities
Investment in debt securities at September 30, 2020 and December 31, 2019 consists mainly of obligations of government-sponsored enterprises, U.S. Treasury securities and obligations of U.S. government instrumentalities, municipal securities, corporate bonds, residential mortgage-backed securities, and collateralized mortgage obligations. The Company classifies its debt securities in one of two categories: available-for-sale or held-to-maturity. Securities classified as held-to-maturity are those securities in which the Company has the ability and intent to hold until maturity. All other securities not included in held-to-maturity are classified as available-for-sale.
Available-for-sale securities are recorded at fair value. The fair values of debt securities (both available-for-sale and held-to-maturity investments) are based on quoted market prices for those or similar investments at the reporting date. Held-to-maturity debt securities are recorded at amortized cost, adjusted for the amortization or accretion of premiums and discounts, respectively. Unrealized holding gains and losses, net of the related tax effect, on available-for-sale securities are excluded from earnings and are reported as a separate component of other comprehensive income until realized. Realized gains and losses from the sale of available-for-sale securities are included in earnings and are determined on a specific identification basis.
Transfers of securities between categories are recorded at fair value at the date of transfer. Unrealized holding gains or losses associated with transfers of securities from held-to-maturity to available-for-sale are recorded as a separate component of other comprehensive income. The unrealized holding gains or losses included in the separate component of other comprehensive income for securities transferred from available-for-sale to held-to-maturity, are maintained and amortized into earnings over the remaining life of the security as an adjustment to yield in a manner consistent with the amortization or accretion of premium or discount on the associated security.
If a fixed maturity security is in an unrealized loss position and the Company does not have the intent to sell the fixed maturity security, or it is more likely than not that the Company will not have to sell the fixed maturity security before recovery of its amortized cost basis, the credit component of the impairment, if any, is recorded as an allowance for credit losses with an offsetting entry in the Company’s consolidated statements of earnings. The non-credit component of the impairment is recognized in other comprehensive income. Furthermore, unrealized losses entirely caused by non-credit related factors related to fixed maturity securities for which the Company expects to fully recover the amortized cost basis continue to be recognized in accumulated other comprehensive income.
If a fixed maturity security is in an unrealized loss position and the Company has the intent to sell the fixed maturity security, or it is more likely than not that the Company will have to sell the fixed maturity security before recovery of its amortized cost basis, the Company will write off any previously recognized allowance for credit losses and will decrease the amortized cost basis of the security. If the allowance has been fully written off and the fair value is less than its amortized cost basis, the amortized cost basis is written down and an impairment loss is recognized in the Company’s consolidated statements of earnings. As of September 30, 2020, no allowance for credit losses was recorded in the condensed consolidated interim financial statements.
The credit component of the impairment is determined by comparing the net present value of projected future cash flows with the amortized cost basis of the fixed maturity security. The net present value is calculated by discounting the Company’s best estimate of projected future cash flows at the effective interest rate implicit in the fixed maturity security at the date of acquisition. If there is an increase in the projected future cash flows of the fixed maturity security in subsequent periods, all or part of the allowance for credit losses may be reversed.
In addition, the Company considers the following factors when evaluating whether a credit loss exist: the reasons for the impairment, the severity of the impairment, market conditions, changes in the security’s rating, changes in value subsequent to year-end, forecasted performance of the investee, and the general market condition in the geographic area or industry the investee operates in.
Premiums and discounts are amortized or accreted over the life of the related held-to-maturity or available-for-sale security as an adjustment to yield using the effective interest method. Dividend and interest income are recognized when earned.
The Company regularly invests in mortgaged-backed securities and other securities subject to prepayment and call risk. Significant changes in prevailing interest rates may adversely affect the timing and amount of cash flows on such securities. In addition, the amortization of market premium and accretion of market discount for mortgaged-backed securities is based on historical experience and estimates of future payment speeds on the underlying mortgage loans. Actual prepayment speeds may differ from original estimates and may result in material adjustments to amortization or accretion recorded in future periods.
Equity investments
Investment in equity securities at September 30, 2020 and December 31, 2019 consists of mutual funds whose underlying assets are comprised of domestic equity securities, international equity securities and higher risk fixed income instruments. Equity investments are recorded at fair value. The fair values of equity investments are mainly based on quoted market prices for those or similar investments at the reporting date. For a specific equity investment, the fair value is estimated using the net asset value (NAV) of the Company’s ownership interest in the partnership. Unrealized holding gains and losses on equity investments are included in earnings. Realized gains and losses from the sale of equity investments are included in earnings and are determined on a specific identification basis.
Other invested assets
Other invested assets at September 30, 2020 and December 31, 2019 consist mainly of alternative investments in partnerships that invest in several private debt and private equity funds. Portfolios are diversified by vintage year, stage, geography, business sectors and number of investments. These investments are not redeemable with the funds. Distributions from each fund are received as the underlying investments of the funds are liquidated. It is estimated that the underlying assets of the funds will be liquidated in the next 5 to 12 years. The fair value of the investments in this class have been estimated using the net asset value (NAV) of the Company’s ownership interest in the partnerships. Total unfunded capital commitments for these positions as of September 30, 2020 amounted to $57,762. The remaining average commitments period is approximately three years.
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Health Insurance Providers Fee |
Health Insurance Providers Fee
The Patient Protection and Affordable Care Act (ACA) as amended by the Health Care and Education Reconciliation Act mandates an annual Health Insurance Providers Fee (HIP Fee). The annual HIP Fee becomes payable to the U.S. Treasury once the entity provides health insurance for any U.S. health risk each applicable calendar year. The initial estimated annual fee is accrued as of January 1, with a corresponding deferred cost that is amortized over 12 months on a straight-line basis. The fee payment is due on September 30 of each year. The deferred cost is included within the other asset line item and the accrued fee is included within the accounts payable and accrued liabilities line item in the accompanying condensed consolidated balance sheets. The fee is presented within operating expenses in the accompanying condensed consolidated statements of earnings. The HIP Fee was waived for all health insurance providers during the year ended December 31, 2019. The Taxpayer Certainty and Disaster Tax Relief Act of 2019 and the Further Consolidated Appropriations Act of 2020, signed into law on December 20, 2019, repealed the HIP Fee effective calendar years beginning after December 31, 2020. As of September 30, 2020, the HIP Fee deferred cost amounted to $12,139. During the quarter ended September 30, 2020, the Company made the corresponding payment amounting to $55,514. As of December 31, 2019, no balance was deferred or accrued for the HIP Fee.
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Recently Adopted Accounting Standards and Future Adoptions of Accounting Standards |
Recently Adopted Accounting Standards
On June 16, 2016, the Financial Accounting Standards Board (FASB) issued guidance to provide financial statement users with more decision-useful information about the expected credit losses on financial instruments and other commitments to extend credit held by a reporting entity at each reporting date by replacing the incurred loss impairment methodology in current U.S. GAAP with a methodology that reflects expected credit losses and requires consideration of a broader range of reasonable and supportable information to inform credit loss estimates. In addition, on April 25, 2019, the FASB issued Accounting Standard Update (ASU) 2019-04: Codification Improvements to Topic 326, Financial Instruments – Credit Losses, Topic 815, Derivatives and Hedging, and Topic 825, Financial Instruments. The amendments in this update represent changes to clarify, correct errors in or improve the codification. Such amendments should make the codification easier to understand and easier to apply by eliminating inconsistencies and providing clarifications. Within the clarifications was the FASB’s intent to include all reinsurance recoverables within the scope of ASU 2016-13 (Topic 326). For public companies, the improvements related to ASU 2016-13 (Topic 326) and ASU 2016-01 (Topic 825) are effective for fiscal years beginning after December 15, 2019, including interim periods within those fiscal years. The Company adopted the standard effective January 1, 2020 and recognized $166, net of deferred tax asset, as a cumulative effect adjustment to the opening balance of retained earnings on the adoption date.
On January 26, 2017, the FASB issued guidance to simplify the manner in which an entity is required to evaluate goodwill for impairment by eliminating Step 2 from the goodwill impairment test. Step 2 measures a goodwill impairment loss by comparing the implied fair value of a reporting unit’s goodwill with the carrying amount of that goodwill. Instead, under the amendments in this guidance, an entity should (1) perform its annual or interim goodwill impairment test by comparing the fair value of a reporting unit with its carrying amount, and (2) recognize an impairment charge for the amount by which the carrying amount exceeds the reporting unit’s fair value, with the understanding that the loss recognized should not exceed the total amount of goodwill allocated to that reporting unit. Additionally, this guidance removes the requirements for any reporting unit with a zero or negative carrying amount to perform a qualitative assessment and, if it fails such qualitative test, to perform Step 2 of the goodwill impairment test. For public companies, these amendments, which should be applied on a prospective basis, are effective for fiscal years beginning after December 15, 2019, including interim periods within those fiscal years. The Company adopted the standard effective January 1, 2020. Upon adoption of this standard, if the carrying amount of any of the reporting units exceeds its fair value, the Company will be required to record an impairment charge for the difference up to the amount of the goodwill.
On August 27, 2018, the FASB issued guidance for Fair Value Measurement – Disclosure Framework – Changes to the Disclosure Requirement for Fair Value Measurement. This update focuses on improving the effectiveness of disclosures in the notes to the financial statements by facilitating clear communication of the information required by U.S. GAAP that is most important to users of each entity’s financial statements. Specifically, certain disclosure requirements are removed (the amount of, and reasons for, transfer between Level 1 and Level 2 of the fair value hierarchy; the policy for timing of transfers between levels; the valuation processes for Level 3 fair value measurements) while certain other disclosures are modified and added (changes in unrealized gains and losses for the period included in other comprehensive income for recurring Level 3 fair value measurements held at the end of the reporting period, and the range and weighted average of significant unobservable inputs used to develop Level 3 fair value measurements). The amendments regarding changes in unrealized gains and losses, the range and weighted average of significant unobservable inputs used to develop Level 3 fair value measurements, and the narrative description of measurement uncertainty should be applied prospectively for only the most recent period in the initial fiscal year of adoption. All other amendments should be applied retrospectively to all periods presented upon their effective date. For public companies, these amendments will be applied for fiscal years beginning after December 15, 2019, including interim periods within those fiscal years. The Company adopted the standard effective January 1, 2020. The adoption of this guidance did not have a material impact on the presentation and disclosures of the Company’s condensed consolidated interim financial statements.
On August 29, 2018, the FASB issued guidance for Intangibles – Goodwill and Other – Internal-Use Software. Guidance addresses customers’ accounting for implemented costs incurred in a cloud computing arrangement that is a service contract and aims to reduce complexity in the accounting for costs of implementing a cloud computing service arrangement. The amendments require a customer in a hosting arrangement that is a service contract to determine which implementation costs to capitalize as an asset related to the service contract and which costs to expense. Additionally, it requires the customer to expense the capitalized implementation costs over the term of the hosting arrangement. For public companies, these amendments will be applied on a prospective basis, for fiscal years beginning after December 15, 2019, including interim periods within those fiscal years. The Company adopted the standard effective January 1, 2020. The adoption of this guidance did not have a material impact on the results of the Company’s condensed consolidated interim financial statements.
Future Adoption of Accounting Standards
On March 12, 2020, the FASB issued ASU 2020-04: Reference Rate Reform (Topic 848): Facilitation of the Effects of Reference Rate Reform on Financial Reporting. The ASU was issued to provide optional guidance, for a limited time, to ease the potential burden in accounting for or recognizing the effects of reference rate reform on financial reporting. The amendments, which are elective and apply to all entities, provide expedients and exceptions for applying U.S. GAAP to contract modifications and hedging relationships affected by reference rate reform if certain criteria are met. The amendments apply only to contracts and hedging relationships that reference LIBOR or another reference rate that is expected to be discontinued due to reference rate reform. Because the guidance is intended to assist stakeholders during the global market-wide reference rate transition period, it is in effect for a limited time, from March 12, 2020 through December 31, 2022. The Company is currently in the process of identifying its LIBOR-based contracts that will be impacted by the phase-out of LIBOR and expects to utilize the optional expedients provided in this ASU.
Other than the accounting pronouncements disclosed above, there were no other new accounting pronouncements issued during the three months and nine months ended September 30, 2020 that could have a material impact on the Company’s financial position, operating results or financials statement disclosures.
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Investment in Securities (Tables) |
9 Months Ended | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Sep. 30, 2020 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Investment in Securities [Abstract] | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Amortized Cost and Estimated Fair Value for Available-for-Sale and Held-to-Maturity Securities by Major Security Type and Class of Security |
The amortized cost for debt securities and cost for alternative investments, gross unrealized gains, gross unrealized losses, and estimated fair value for the Company’s investments in securities by major security type and class of security at September 30, 2020 and December 31, 2019, were as follows:
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Securities in Continuous Unrealized Loss Position |
Gross unrealized losses on investment securities and the estimated fair value of the related securities, aggregated by investment category and length of time that individual securities have been in a continuous unrealized loss position as of September 30, 2020 and December 31, 2019 were as follows:
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Maturities of Investment Securities Classified as Available for Sale and Held to Maturity |
Maturities of investment securities classified as available for sale and held to maturity were as follows:
|
Realized and Unrealized Gains (Losses) (Tables) |
9 Months Ended | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Sep. 30, 2020 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Realized and Unrealized Gains (Losses) [Abstract] | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Realized Gains and Losses from Investments |
Information regarding realized and unrealized gains and losses from investments is as follows:
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Changes in Net Unrealized Gains (Losses) |
The gross losses from impaired securities during the nine months ended September 30, 2020 is related to an equity method investment held by the Company.
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Premiums and Other Receivables, Net (Tables) |
9 Months Ended | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Sep. 30, 2020 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Premiums and Other Receivables, Net [Abstract] | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Premiums and Other Receivables, Net |
Premiums and other receivables, net were as follows:
|
Property and Equipment, Net (Tables) |
9 Months Ended | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Sep. 30, 2020 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Property and Equipment, Net [Abstract] | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Property and Equipment, Net |
Property and equipment, net are composed of the following:
|
Fair Value Measurements (Tables) |
9 Months Ended | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Sep. 30, 2020 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Fair Value Measurements [Abstract] | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Fair Value Measurements by Level for Assets Measured at Fair Value on a Recurring Basis |
The following tables summarize fair value measurements by level for assets measured at fair value on a recurring basis:
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Reconciliation of Assets Measured at Fair Value on Recurring Basis |
A reconciliation of the beginning and ending balances of assets measured at fair value on a recurring basis using significant unobservable inputs (Level 3) for the three months and nine months ended September 30 is as follows:
|
Claim Liabilities (Tables) |
9 Months Ended | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Sep. 30, 2020 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Claim Liabilities [Abstract] | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Reconciliation of Beginning and Ending Balances of Claim Liabilities |
A reconciliation of the beginning and ending balances of claim liabilities is as follows:
* Other Business Segments include the Life Insurance and Property and Casualty segments, as well as intersegment eliminations.
* Other Business Segments include the Life Insurance and Property and Casualty segments, as well as intersegment eliminations.
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Incurred But Not Reported (IBNR) Liabilities Plus Expected Development on Reported Claims Included in the Liability for Unpaid Claims Adjustment Expenses |
The following is information about total incurred but not reported (IBNR) liabilities plus expected development on reported claims included in the liability for unpaid claims adjustment expenses for the Managed Care segment as of September 30, 2020.
|
Borrowings (Tables) |
9 Months Ended | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Sep. 30, 2020 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Borrowings [Abstract] | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Summary of Borrowings |
A summary of the borrowings entered by the Company are as follows:
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Aggregate Maturities of Company's Long Term Borrowings |
Aggregate maturities of the Company’s borrowings as of September 30, 2020 are summarized as follows:
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Pension Plan (Tables) |
9 Months Ended | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Sep. 30, 2020 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Pension Plan [Abstract] | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Components of Net Periodic Benefit |
The components of net periodic benefit cost were as follows:
|
Leases (Tables) |
9 Months Ended | |||||||||||||||||||||||||||||||||||||||||||||
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Sep. 30, 2020 | ||||||||||||||||||||||||||||||||||||||||||||||
Leases [Abstract] | ||||||||||||||||||||||||||||||||||||||||||||||
Undiscounted Cash Flows of Operating Leases |
Undiscounted cash flows of operating leases are summarized as follows:
|
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Lease Cost |
At December 31, 2019, operating lease commitments under lessee arrangements were $4,713, $3,790, $3,200, $2,171, $1,710 and $2,707 for 2020 through 2024 and thereafter, respectively. The following presents the lease cost recognized by the Company:
|
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Maturity Analysis of Lease Payments to be Received |
Also, the Company leases certain floors of one of its buildings and generates rental income. Maturity analysis of lease payments to be received from its lessees as of September 30, 2020, is summarized as follows:
|
Comprehensive Income (Loss) (Tables) |
9 Months Ended | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Comprehensive Income (Loss) [Abstract] | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Accumulated Balances of Other Comprehensive Income (Loss), Net of Tax |
The accumulated balances for each classification of other comprehensive income (loss), net of tax, are as follows:
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Net Income Available to Stockholders and Net Income per Share (Tables) |
9 Months Ended | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Sep. 30, 2020 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Net Income Available to Stockholders and Net Income per Share [Abstract] | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Computation of Basic and Diluted Earnings Per Share |
The following table sets forth the computation of basic and diluted earnings per share:
|
Segment Information (Tables) |
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Segment Information [Abstract] | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Operating Revenues by Major Operating Segment |
The following tables summarize the operations by reportable segment for the three months and nine months ended September 30, 2020 and 2019:
* Includes segments that are not required to be reported separately, primarily the health clinics.
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Operating Income (Loss) and Depreciation and Amortization Expense |
* Includes segments that are not required to be reported separately, primarily the health clinics.
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Assets |
* Includes segments that are not required to be reported separately, primarily the health clinics.
|
Investment in Securities, Fixed Maturities Held to Maturity (Details) - USD ($) $ in Thousands |
Sep. 30, 2020 |
Dec. 31, 2019 |
---|---|---|
Fixed maturities held to maturity [Abstract] | ||
Amortized cost | $ 1,867 | $ 1,860 |
Gross unrealized gains | 223 | 159 |
Gross unrealized losses | 0 | 0 |
Estimated fair value | 2,090 | 2,019 |
U.S. Treasury Securities and Obligations of U.S. Government Instrumentalities [Member] | ||
Fixed maturities held to maturity [Abstract] | ||
Amortized cost | 614 | 615 |
Gross unrealized gains | 217 | 158 |
Gross unrealized losses | 0 | 0 |
Estimated fair value | 831 | 773 |
Residential Mortgage-backed Securities [Member] | ||
Fixed maturities held to maturity [Abstract] | ||
Amortized cost | 165 | 165 |
Gross unrealized gains | 6 | 1 |
Gross unrealized losses | 0 | 0 |
Estimated fair value | 171 | 166 |
Certificates of Deposit [Member] | ||
Fixed maturities held to maturity [Abstract] | ||
Amortized cost | 1,088 | 1,080 |
Gross unrealized gains | 0 | 0 |
Gross unrealized losses | 0 | 0 |
Estimated fair value | $ 1,088 | $ 1,080 |
Investment in Securities, Other Invested Assets - Alternative Investments (Details) - Other Invested Assets - Alternative investments [Member] - USD ($) $ in Thousands |
Sep. 30, 2020 |
Dec. 31, 2019 |
---|---|---|
Other invested assets - Alternative investments [Abstract] | ||
Amortized cost | $ 110,532 | $ 97,575 |
Gross unrealized gains | 3,795 | 3,721 |
Gross unrealized losses | (3,562) | (788) |
Estimated fair value | $ 110,765 | $ 100,508 |
Premiums and Other Receivables, Net (Details) - USD ($) $ in Thousands |
Sep. 30, 2020 |
Dec. 31, 2019 |
---|---|---|
Premiums and other receivables, net [Abstract] | ||
Premium | $ 135,133 | $ 188,861 |
Self-funded group receivables | 26,310 | 28,672 |
FEHBP | 14,499 | 13,894 |
Agent balances | 34,224 | 30,784 |
Accrued interest | 9,753 | 11,307 |
Reinsurance recoverable | 222,966 | 239,767 |
Other | 153,839 | 110,952 |
Premiums and other receivables, total | 596,724 | 624,237 |
Less allowance for doubtful receivables [Abstract] | ||
Premium | 37,489 | 36,622 |
Other | 12,276 | 19,923 |
Premiums and other receivables, allowance | 49,765 | 56,545 |
Total premium and other receivables, net | 546,959 | 567,692 |
Government of Puerto Rico [Member] | ||
Premiums and other receivables, net [Abstract] | ||
Premiums and other receivables, total | 71,322 | 49,176 |
Less allowance for doubtful receivables [Abstract] | ||
Premiums and other receivables, allowance | $ 24,268 | $ 22,091 |
Fair Value Measurements, Reconciliation of Assets Measured at Fair Value Using Significant Unobservable Inputs (Level 3) (Details) - USD ($) $ in Thousands |
3 Months Ended | 9 Months Ended | |
---|---|---|---|
Sep. 30, 2020 |
Sep. 30, 2020 |
Dec. 31, 2019 |
|
Fair Value Measurements [Abstract] | |||
Level 1 to level 2 transfers | $ 0 | $ 0 | $ 0 |
Level 2 to level 1 transfers | 0 | 0 | $ 0 |
Reconciliation of beginning and ending balances of assets measured at fair value on a recurring basis using significant unobservable inputs (Level 3) [Roll Forward] | |||
Beginning Balance | 5,237 | 5,209 | |
Unrealized in other accumulated comprehensive income | (71) | (43) | |
Ending Balance | $ 5,166 | $ 5,166 |
Claim Liabilities, Incurred But Not Reported (IBNR) Liabilities Plus Expected Development on Reported Claims Included in the Liability for Unpaid Claims Adjustment Expenses (Details) - Managed Care [Member] $ in Thousands |
Sep. 30, 2020
USD ($)
|
---|---|
Incurred Year 2019 [Member] | |
Insurance Claims Development, Net of Reinsurance [Abstract] | |
Total of IBNR liabilities plus expected development on reported claims | $ 29,283 |
Incurred Year 2020 [Member] | |
Insurance Claims Development, Net of Reinsurance [Abstract] | |
Total of IBNR liabilities plus expected development on reported claims | $ 322,425 |
Borrowings (Details) - USD ($) $ in Thousands |
9 Months Ended | |
---|---|---|
Sep. 30, 2020 |
Dec. 31, 2019 |
|
Summary of long-term borrowings [Abstract] | ||
Total borrowings | $ 54,489 | $ 25,879 |
Less: unamortized debt issuance costs | 653 | 185 |
Long-term borrowings | 53,836 | 25,694 |
Aggregate maturities of Company's long term borrowings [Abstract] | ||
Remaining of 2020 | 1,122 | |
2021 | 4,490 | |
2022 | 4,490 | |
2023 | 4,196 | |
2024 | 14,484 | |
Thereafter | 25,707 | |
Total borrowings | 54,489 | 25,879 |
Outstanding balance | $ 82,500 | $ 54,000 |
Average interest rate of outstanding balance | 0.34% | 1.79% |
TSS [Member] | ||
Aggregate maturities of Company's long term borrowings [Abstract] | ||
Borrowing capacity of admitted assets percentage | 30.00% | |
Maximum borrowing capacity | $ 119,329 | $ 82,200 |
Outstanding balance | $ 62,500 | 25,000 |
TSV [Member] | ||
Aggregate maturities of Company's long term borrowings [Abstract] | ||
Borrowing capacity of admitted assets percentage | 30.00% | |
Maximum borrowing capacity | $ 87,940 | 48,900 |
Outstanding balance | 20,000 | 29,000 |
Secured Debt [Member] | Term Loan A [Member] | ||
Summary of long-term borrowings [Abstract] | ||
Total borrowings | 5,037 | 6,267 |
Debt instrument, principal amount | $ 11,187 | |
Debt instrument, maturity date | Oct. 01, 2023 | |
Debt instrument, monthly installment payment | $ 137 | |
Basis spread on variable rate | 1.00% | |
Debt instrument, variable interest rate | 1.16% | |
Aggregate maturities of Company's long term borrowings [Abstract] | ||
Total borrowings | $ 5,037 | 6,267 |
Secured Debt [Member] | Term Loan B [Member] | ||
Summary of long-term borrowings [Abstract] | ||
Total borrowings | 16,456 | 17,211 |
Debt instrument, principal amount | $ 20,150 | |
Debt instrument, maturity date | Jan. 01, 2024 | |
Debt instrument, monthly installment payment | $ 84 | |
Basis spread on variable rate | 2.75% | |
Debt instrument, variable interest rate | 3.05% | |
Aggregate maturities of Company's long term borrowings [Abstract] | ||
Total borrowings | $ 16,456 | 17,211 |
Secured Debt [Member] | Term Loan C [Member] | ||
Summary of long-term borrowings [Abstract] | ||
Total borrowings | 1,960 | 2,401 |
Debt instrument, principal amount | $ 4,116 | |
Debt instrument, maturity date | Jan. 01, 2024 | |
Debt instrument, monthly installment payment | $ 49 | |
Basis spread on variable rate | 3.25% | |
Debt instrument, variable interest rate | 3.55% | |
Aggregate maturities of Company's long term borrowings [Abstract] | ||
Total borrowings | $ 1,960 | 2,401 |
Secured Debt [Member] | Term Loan D [Member] | ||
Summary of long-term borrowings [Abstract] | ||
Total borrowings | 31,036 | 0 |
Debt instrument, principal amount | $ 31,350 | |
Debt instrument, maturity date | May 01, 2025 | |
Debt instrument, monthly installment payment | $ 105 | |
Debt instrument, variable interest rate | 3.22% | |
Debt instrument, last payment | $ 25,185 | |
Debt Instrument, last payment maturity date | Jun. 19, 2025 | |
Aggregate maturities of Company's long term borrowings [Abstract] | ||
Total borrowings | $ 31,036 | $ 0 |
Commercial Bank in Puerto Rico [Member] | First Year [Member] | ||
Aggregate maturities of Company's long term borrowings [Abstract] | ||
Prepayment penalty fee percentage | 3.00% | |
Commercial Bank in Puerto Rico [Member] | Second Year [Member] | ||
Aggregate maturities of Company's long term borrowings [Abstract] | ||
Prepayment penalty fee percentage | 2.00% | |
Commercial Bank in Puerto Rico [Member] | Third Year [Member] | ||
Aggregate maturities of Company's long term borrowings [Abstract] | ||
Prepayment penalty fee percentage | 1.00% | |
Commercial Bank in Puerto Rico [Member] | TSA [Member] | ||
Aggregate maturities of Company's long term borrowings [Abstract] | ||
Maximum borrowing capacity | $ 10,000 | |
Outstanding balance | $ 0 | |
Expiration date | Jun. 30, 2021 | |
Commercial Bank in Puerto Rico [Member] | TSA [Member] | LIBOR [Member] | ||
Summary of long-term borrowings [Abstract] | ||
Basis spread on variable rate | 2.50% | |
Aggregate maturities of Company's long term borrowings [Abstract] | ||
Variable rate, term | 30 days |
Pension Plan (Details) - USD ($) $ in Thousands |
3 Months Ended | 9 Months Ended | |||
---|---|---|---|---|---|
Sep. 30, 2020 |
Sep. 30, 2019 |
Sep. 30, 2020 |
Sep. 30, 2019 |
Dec. 31, 2019 |
|
Components of net periodic benefit cost [Abstract] | |||||
Interest cost | $ 1,474 | $ 1,748 | $ 4,554 | $ 5,230 | |
Expected return on assets | (2,211) | (2,209) | (6,629) | (6,643) | |
Amortization of actuarial loss | 396 | 98 | 884 | 277 | |
Settlement loss | 356 | 555 | 1,068 | 1,305 | |
Net periodic benefit cost (income) | $ 15 | $ 192 | (123) | $ 169 | |
Expected employer future contributions | $ 2,000 | ||||
Employer contribution | $ 10,000 |
Stock Repurchase Programs (Details) - 2017 $30,000 Stock Repurchase Program [Member] - USD ($) $ / shares in Units, $ in Thousands |
3 Months Ended | 9 Months Ended | |||||
---|---|---|---|---|---|---|---|
Sep. 30, 2020 |
Sep. 30, 2019 |
Sep. 30, 2020 |
Sep. 30, 2019 |
Oct. 31, 2019 |
Feb. 28, 2018 |
Aug. 31, 2017 |
|
Stock Repurchase Programs [Abstract] | |||||||
Shares repurchased (in shares) | 0 | 0 | 952,820 | 0 | |||
Average share price (in dollars per share) | $ 15.72 | ||||||
Amount repurchases | $ 14,982 | ||||||
Class B Common Stock [Member] | |||||||
Stock Repurchase Programs [Abstract] | |||||||
Stock repurchase program, authorized amount | $ 25,000 | $ 25,000 | $ 30,000 |
Reinsurance (Details) - TSP [Member] - USD ($) $ in Thousands |
3 Months Ended | 9 Months Ended | ||
---|---|---|---|---|
Sep. 30, 2020 |
Sep. 30, 2019 |
Sep. 30, 2020 |
Sep. 30, 2019 |
|
Reinsurance Activity [Abstract] | ||||
Ceded premiums written | $ 14,920 | $ 12,355 | $ 45,637 | $ 36,028 |
Ceded incurred loss adjustment expenses | $ 5,419 | $ 1,089 | 45,802 | $ 6,531 |
Claims ceded | 40,000 | |||
Casualty Excess of Loss Treaty [Member] | Minimum [Member] | ||||
Reinsurance Activity [Abstract] | ||||
Amount of claim covered, per person | 225 | |||
Casualty Excess of Loss Treaty [Member] | Maximum [Member] | ||||
Reinsurance Activity [Abstract] | ||||
Amount of claim covered, per person | 20,000 | |||
Medical Malpractice Excess of Loss [Member] | Minimum [Member] | ||||
Reinsurance Activity [Abstract] | ||||
Amount of claim covered, per person | 150 | |||
Medical Malpractice Excess of Loss [Member] | Maximum [Member] | ||||
Reinsurance Activity [Abstract] | ||||
Amount of claim covered, per person | 3,000 | |||
Property Reinsurance Treaty [Member] | Minimum [Member] | ||||
Reinsurance Activity [Abstract] | ||||
Amount of claim covered, per person | 400 | |||
Property Reinsurance Treaty [Member] | Maximum [Member] | ||||
Reinsurance Activity [Abstract] | ||||
Amount of claim covered, per person | 30,000 | |||
Catastrophe [Member] | ||||
Reinsurance Activity [Abstract] | ||||
Maximum amount of claim to be covered per person | 814,000 | |||
Catastrophe [Member] | Minimum [Member] | ||||
Reinsurance Activity [Abstract] | ||||
Amount of claim covered, per person | 5,000 | |||
Catastrophe [Member] | Maximum [Member] | ||||
Reinsurance Activity [Abstract] | ||||
Amount of claim covered, per person | $ 809,000 |
Leases (Details) - USD ($) $ in Thousands |
Sep. 30, 2020 |
Dec. 31, 2019 |
---|---|---|
Operating Lease [Abstract] | ||
us-gaap_OtherAssets | us-gaap:OperatingLeaseRightOfUseAssetStatementOfFinancialPositionExtensibleList | |
us-gaap_AccountsPayableAndAccruedLiabilitiesCurrentAndNoncurrent | us-gaap:OperatingLeaseLiabilityStatementOfFinancialPositionExtensibleList | |
Right-of-use asset | $ 13,929 | $ 10,438 |
Lease liabilities | $ 14,171 | $ 10,586 |
Weighted-average remaining lease term | 5 years 10 months 24 days | |
Weighted-average discount rate of operating leases | 5.20% | |
Minimum [Member] | ||
Operating Lease [Abstract] | ||
Remaining lease term | 2 months 12 days | |
Maximum [Member] | ||
Operating Lease [Abstract] | ||
Remaining lease term | 14 years 2 months 12 days |
Leases, Undiscounted Cash Flows of Operating Leases (Details) - USD ($) $ in Thousands |
Sep. 30, 2020 |
Dec. 31, 2019 |
---|---|---|
Undiscounted Cash Flows of Operating Leases [Abstract] | ||
Remaining of 2020 | $ 1,062 | |
2021 | 3,998 | $ 4,713 |
2022 | 3,420 | 3,790 |
2023 | 2,329 | 3,200 |
2024 | 1,855 | 2,171 |
Thereafter | 3,590 | |
Total lease payments | 16,254 | |
Less: imputed interest | (2,083) | |
Total | $ 14,171 | $ 10,586 |
Leases, Operating Lease Commitments and Lease Cost (Details) - USD ($) $ in Thousands |
9 Months Ended | |
---|---|---|
Sep. 30, 2020 |
Dec. 31, 2019 |
|
Operating Lease Commitments under Lessee Arrangements [Abstract] | ||
2020 | $ 3,998 | $ 4,713 |
2021 | 3,420 | 3,790 |
2022 | 2,329 | 3,200 |
2023 | 1,855 | 2,171 |
2024 | 1,710 | |
Thereafter | $ 2,707 | |
Lease Cost [Abstract] | ||
Operating lease cost | 3,570 | |
Short-term lease cost | 801 | |
Total lease cost | $ 4,371 |
Leases, Maturity Analysis of Lease Payments to be Received (Details) $ in Thousands |
Sep. 30, 2020
USD ($)
|
---|---|
Maturity Analysis of Lease Payments to be Received [Abstract] | |
Remaining of 2020 | $ 473 |
2021 | 1,909 |
2022 | 1,947 |
2023 | 1,986 |
2024 | 2,026 |
Thereafter | 2,624 |
Total | $ 10,965 |
Comprehensive Income (Loss) (Details) - USD ($) $ in Thousands |
3 Months Ended | 9 Months Ended | ||
---|---|---|---|---|
Sep. 30, 2020 |
Sep. 30, 2019 |
Sep. 30, 2020 |
Sep. 30, 2019 |
|
Accumulated balances for each classification of other comprehensive income, net of tax [Roll Forward] | ||||
Balance | $ 979,535 | $ 921,389 | $ 943,172 | $ 821,308 |
Total other comprehensive income, net of tax | 4,990 | 9,351 | 32,576 | 37,833 |
Balance | 1,009,687 | 948,691 | 1,009,687 | 948,691 |
Net Unrealized Gain on Securities [Member] | ||||
Accumulated balances for each classification of other comprehensive income, net of tax [Roll Forward] | ||||
Balance | 85,110 | 55,678 | 57,830 | 27,308 |
Other comprehensive income before reclassifications | 5,149 | 10,160 | 31,879 | 41,473 |
Amounts reclassified from accumulated other comprehensive (loss) income | (406) | (870) | 144 | (3,813) |
Total other comprehensive income, net of tax | 4,743 | 9,290 | 32,023 | 37,660 |
Balance | 89,853 | 64,968 | 89,853 | 64,968 |
Liability for Pension Benefits [Member] | ||||
Accumulated balances for each classification of other comprehensive income, net of tax [Roll Forward] | ||||
Balance | (28,161) | (24,134) | (28,467) | (24,246) |
Amounts reclassified from accumulated other comprehensive (loss) income | 247 | 61 | 553 | 173 |
Balance | (27,914) | (24,073) | (27,914) | (24,073) |
Accumulated Other Comprehensive Income (Loss) [Member] | ||||
Accumulated balances for each classification of other comprehensive income, net of tax [Roll Forward] | ||||
Balance | 56,949 | 31,544 | 29,363 | 3,062 |
Other comprehensive income before reclassifications | 5,149 | 10,160 | 31,879 | 41,473 |
Amounts reclassified from accumulated other comprehensive (loss) income | (159) | (809) | 697 | (3,640) |
Total other comprehensive income, net of tax | 4,990 | 9,351 | 32,576 | 37,833 |
Balance | $ 61,939 | $ 40,895 | $ 61,939 | $ 40,895 |
Share-Based Compensation (Details) - USD ($) $ in Thousands |
3 Months Ended | 9 Months Ended | ||
---|---|---|---|---|
Sep. 30, 2020 |
Sep. 30, 2019 |
Sep. 30, 2020 |
Sep. 30, 2019 |
|
Share-Based Compensation [Abstract] | ||||
Share-based compensation expense | $ 1,849 | $ 2,817 | $ 8,443 | $ 8,723 |
Shares repurchased and retired as a result of non-cash tax withholdings upon vesting of shares (in shares) | 14,040 | 0 | 20,922 | 602 |
Net Income Available to Stockholders and Net Income per Share (Details) - USD ($) $ / shares in Units, $ in Thousands |
3 Months Ended | 9 Months Ended | ||
---|---|---|---|---|
Sep. 30, 2020 |
Sep. 30, 2019 |
Sep. 30, 2020 |
Sep. 30, 2019 |
|
Numerator for earnings per share [Abstract] | ||||
Net income attributable to TSM available to stockholders | $ 23,581 | $ 13,948 | $ 41,035 | $ 79,665 |
Denominator for basic earnings per share [Abstract] | ||||
Weighted average of common shares (in shares) | 23,073,511 | 23,830,106 | 23,215,840 | 23,143,361 |
Effect of dilutive securities (in shares) | 120,469 | 63,701 | 102,229 | 73,937 |
Denominator for diluted earnings per share (in shares) | 23,193,980 | 23,893,807 | 23,318,069 | 23,217,298 |
Basic net income per share attributable to TSM (in dollars per share) | $ 1.02 | $ 0.59 | $ 1.77 | $ 3.44 |
Diluted net income per share attributable to TSM (in dollars per share) | $ 1.02 | $ 0.58 | $ 1.76 | $ 3.43 |
Contingencies (Details) $ in Thousands |
9 Months Ended | |
---|---|---|
Jan. 12, 2015
USD ($)
|
Sep. 30, 2020
USD ($)
Lawsuit
shares
|
|
Minimum [Member] | ||
Contingencies [Abstract] | ||
Loss contingency, possible losses | $ 0 | |
Maximum [Member] | ||
Contingencies [Abstract] | ||
Loss contingency, possible losses | $ 10,000 | |
Claims by Heirs of Former Shareholders [Member] | ||
Contingencies [Abstract] | ||
Number of lawsuits filed | Lawsuit | 4 | |
Number of shares claimed to have inherited (in shares) | shares | 41 | |
Stock split conversion ratio | 3,000 | |
In re Blue Cross Blue Shield Antitrust Litigation [Member] | ||
Contingencies [Abstract] | ||
Accrued liability related to legal proceedings | $ 32,000 | |
Complaint by American Clinical Solutions LLC [Member] | Insurance Claims [Member] | Triple-S Salud, Inc [Member] | ||
Contingencies [Abstract] | ||
Amount of claims sought for damages | $ 5,000 |
Segment Information (Details) $ in Thousands |
3 Months Ended | 9 Months Ended | |||||
---|---|---|---|---|---|---|---|
Sep. 30, 2020
USD ($)
|
Sep. 30, 2019
USD ($)
|
Sep. 30, 2020
USD ($)
Segment
|
Sep. 30, 2019
USD ($)
|
Dec. 31, 2019
USD ($)
|
|||
Segment Information [Abstract] | |||||||
Number of operating segments | Segment | 3 | ||||||
Operating revenues [Abstract] | |||||||
Premiums, net | $ 922,934 | $ 815,021 | $ 2,657,366 | $ 2,442,516 | |||
Administrative service fees | 3,752 | 2,607 | 8,755 | 7,695 | |||
Net investment income | 14,168 | 15,176 | 42,294 | 45,614 | |||
Consolidated operating revenues | 942,906 | 835,971 | 2,714,809 | 2,502,160 | |||
Operating income (loss) [Abstract] | |||||||
Consolidated operating income | 22,305 | 19,079 | 85,739 | 89,027 | |||
Consolidated net realized investment gains (losses) | 507 | 1,087 | (180) | 4,766 | |||
Consolidated net unrealized investment gains (losses) on equity investments | 11,040 | 1,267 | (17,428) | 24,259 | |||
Consolidated interest expense | (2,096) | (2,062) | (5,813) | (5,681) | |||
Consolidated other income, net | 1,811 | 485 | 6,217 | 3,359 | |||
Consolidated income before taxes | 33,567 | 19,856 | 68,535 | 115,730 | |||
Depreciation and amortization expense [Abstract] | |||||||
Depreciation and amortization expense | 3,111 | 3,684 | 10,855 | 10,729 | |||
Assets [Abstract] | |||||||
Assets | 3,120,287 | 3,120,287 | $ 2,818,826 | ||||
Cash, cash equivalents, and investments | 2,003,934 | 2,003,934 | 1,753,474 | ||||
Property and equipment, net | 130,220 | 130,220 | 88,588 | ||||
Other assets | 98,260 | 98,260 | 68,294 | ||||
Other Segments [Member] | |||||||
Operating revenues [Abstract] | |||||||
TSM operating revenues from external sources | [1] | 2,052 | 3,167 | 6,394 | 6,335 | ||
Consolidated operating revenues | [1] | 4,647 | 5,243 | 14,031 | 12,384 | ||
Operating income (loss) [Abstract] | |||||||
Operating income (loss) | [1] | (1,639) | (690) | (4,552) | (1,812) | ||
TSM operating revenues from external sources | [1] | 2,052 | 3,167 | 6,394 | 6,335 | ||
Depreciation and amortization expense [Abstract] | |||||||
Depreciation and amortization expense | [1] | 240 | 249 | 913 | 627 | ||
Assets [Abstract] | |||||||
Assets | [1] | 30,408 | 30,408 | 28,346 | |||
Reportable Segment [Member] | |||||||
Operating revenues [Abstract] | |||||||
Consolidated operating revenues | 945,975 | 839,844 | 2,726,727 | 2,513,600 | |||
Operating income (loss) [Abstract] | |||||||
Operating income (loss) | 21,435 | 18,009 | 83,052 | 87,492 | |||
Depreciation and amortization expense [Abstract] | |||||||
Depreciation and amortization expense | 2,707 | 3,534 | 10,139 | 10,186 | |||
Assets [Abstract] | |||||||
Assets | 3,080,257 | 3,080,257 | 2,793,012 | ||||
Reportable Segment [Member] | Managed Care [Member] | |||||||
Operating revenues [Abstract] | |||||||
Premiums, net | 849,529 | 746,043 | 2,447,588 | 2,244,448 | |||
Administrative service fees | 3,013 | 2,607 | 8,755 | 7,695 | |||
Net investment income | 5,065 | 5,624 | 14,763 | 16,981 | |||
Consolidated operating revenues | 858,251 | 755,757 | 2,473,730 | 2,273,736 | |||
Operating income (loss) [Abstract] | |||||||
Operating income (loss) | 13,006 | 5,393 | 56,495 | 56,805 | |||
Depreciation and amortization expense [Abstract] | |||||||
Depreciation and amortization expense | 2,085 | 2,931 | 8,061 | 8,480 | |||
Assets [Abstract] | |||||||
Assets | 1,406,356 | 1,406,356 | 1,190,538 | ||||
Reportable Segment [Member] | Life Insurance [Member] | |||||||
Operating revenues [Abstract] | |||||||
Premiums, net | 49,616 | 45,365 | 143,325 | 133,598 | |||
Net investment income | 6,900 | 6,709 | 20,625 | 20,091 | |||
Consolidated operating revenues | 57,032 | 52,545 | 165,502 | 155,146 | |||
Operating income (loss) [Abstract] | |||||||
Operating income (loss) | 5,682 | 6,686 | 20,188 | 17,541 | |||
Depreciation and amortization expense [Abstract] | |||||||
Depreciation and amortization expense | 289 | 268 | 869 | 813 | |||
Assets [Abstract] | |||||||
Assets | 1,039,765 | 1,039,765 | 981,370 | ||||
Reportable Segment [Member] | Property and Casualty Insurance [Member] | |||||||
Operating revenues [Abstract] | |||||||
Premiums, net | 23,789 | 23,613 | 66,453 | 64,470 | |||
Net investment income | 2,103 | 2,533 | 6,551 | 7,404 | |||
Consolidated operating revenues | 26,045 | 26,299 | 73,464 | 72,334 | |||
Operating income (loss) [Abstract] | |||||||
Operating income (loss) | 4,386 | 6,620 | 10,921 | 14,958 | |||
Depreciation and amortization expense [Abstract] | |||||||
Depreciation and amortization expense | 93 | 86 | 296 | 266 | |||
Assets [Abstract] | |||||||
Assets | 603,728 | 603,728 | 592,758 | ||||
Unallocated Amount to Segment [Member] | |||||||
Operating revenues [Abstract] | |||||||
TSM operating revenues from external sources | 100 | 310 | 355 | 1,138 | |||
Operating income (loss) [Abstract] | |||||||
TSM operating revenues from external sources | 100 | 310 | 355 | 1,138 | |||
TSM unallocated operating expenses | (1,633) | (1,643) | (4,877) | (6,812) | |||
Depreciation and amortization expense [Abstract] | |||||||
Depreciation and amortization expense | 404 | 150 | 716 | 543 | |||
Assets [Abstract] | |||||||
Assets | 133,124 | 133,124 | 90,966 | ||||
Cash, cash equivalents, and investments | 19,881 | 19,881 | 28,167 | ||||
Property and equipment, net | 67,316 | 67,316 | 25,623 | ||||
Other assets | 45,927 | 45,927 | 37,176 | ||||
Intersegment Elimination [Member] | |||||||
Operating revenues [Abstract] | |||||||
Premiums, net | (574) | (2,107) | (4,636) | (6,529) | |||
Consolidated operating revenues | (2,595) | (2,076) | (7,637) | (6,049) | |||
Operating income (loss) [Abstract] | |||||||
Elimination of TSM intersegment charges | 2,403 | 2,403 | 7,209 | 7,209 | |||
Assets [Abstract] | |||||||
Assets | (93,094) | (93,094) | $ (65,152) | ||||
Intersegment Elimination [Member] | Managed Care [Member] | |||||||
Operating revenues [Abstract] | |||||||
Premiums, net | 644 | 1,483 | 2,624 | 4,612 | |||
Intersegment Elimination [Member] | Life Insurance [Member] | |||||||
Operating revenues [Abstract] | |||||||
Premiums, net | 516 | 471 | 1,552 | 1,457 | |||
Intersegment Elimination [Member] | Property and Casualty Insurance [Member] | |||||||
Operating revenues [Abstract] | |||||||
Premiums, net | 153 | 153 | 460 | 460 | |||
Intersegment Elimination [Member] | Other Segments [Member] | |||||||
Operating revenues [Abstract] | |||||||
Consolidated operating revenues | [1] | $ 2,595 | $ 2,076 | $ 7,637 | $ 6,049 | ||
|
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