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