0001209191-21-012074.txt : 20210218 0001209191-21-012074.hdr.sgml : 20210218 20210218183244 ACCESSION NUMBER: 0001209191-21-012074 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210216 FILED AS OF DATE: 20210218 DATE AS OF CHANGE: 20210218 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Roman Jimenez Juan Jose CENTRAL INDEX KEY: 0001317669 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-33865 FILM NUMBER: 21651152 MAIL ADDRESS: STREET 1: PO BOX 364527 CITY: SAN JUAN STATE: PR ZIP: 00936 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: TRIPLE-S MANAGEMENT CORP CENTRAL INDEX KEY: 0001171662 STANDARD INDUSTRIAL CLASSIFICATION: ACCIDENT & HEALTH INSURANCE [6321] IRS NUMBER: 660555678 STATE OF INCORPORATION: PR FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 1441 F.D. ROOSEVELT AVE. CITY: SAN JUAN STATE: PR ZIP: 00920 BUSINESS PHONE: 7877494949 MAIL ADDRESS: STREET 1: 1441 F.D. ROOSEVELT AVE. CITY: SAN JUAN STATE: PR ZIP: 00920 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2021-02-16 0 0001171662 TRIPLE-S MANAGEMENT CORP GTS 0001317669 Roman Jimenez Juan Jose P.O. BOX 363628 SAN JUAN PR 00936 PUERTO RICO 0 1 0 0 EVP & CFO Class B Common Stock 2021-02-16 4 A 0 22785 0.00 A 131728 D Shares acquired represent common stock earned pursuant to a grant of Performance Shares on March 6, 2018. The Performance Shares resulting in the issuance of these shares of common stock did not constitute derivative securities. As a result, such Performance Shares were not required to be reported and were not reported on a Form 4 at the time of the award. /s/ Manuel Rodriguez-Boissen, Attorney-in-fact 2021-02-18