0001209191-22-007021.txt : 20220203 0001209191-22-007021.hdr.sgml : 20220203 20220203192601 ACCESSION NUMBER: 0001209191-22-007021 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20220201 FILED AS OF DATE: 20220203 DATE AS OF CHANGE: 20220203 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Clavell Luis A CENTRAL INDEX KEY: 0001361825 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-33865 FILM NUMBER: 22590362 MAIL ADDRESS: STREET 1: PO BOX 363628 CITY: SAN JUAN STATE: PR ZIP: 00936-3628 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 2022-02-01 1 0001171662 TRIPLE-S MANAGEMENT CORP GTS 0001361825 Clavell Luis A PO BOX 363628 SAN JUAN PR 00936-3628 PUERTO RICO 1 0 0 0 Common Stock 2022-02-01 4 D 0 76320 36.00 D 0 D The amount of securities beneficially owned reported in Column 4 includes certain Restricted Stock Units that were accelerated and vested in accordance with the terms of the Merger Agreement between Triple-S Management Corporation (the "Issuer"), GuideWell Mutual Holding Corporation and GuideWell Merger, Inc. dated August 23, 2021 (the "Merger Agreement"). Pursuant to the terms of the Merger Agreement, all issued and outstanding shares of the Issuer were acquired at $36 per share. /s/ Manuel Rodriguez-Boissen, Attorney-in-Fact 2022-02-03