SAN JUAN, Puerto Rico,
Nov. 6, 2020 /PRNewswire/ -- Triple-S
Management Corporation (NYSE: GTS), a leading healthcare care
company in Puerto Rico, today
announced its third quarter 2020 results.
"Our strong third quarter performance reflects ongoing, improved
performance resulting from our operational focus and enhanced
organizational capabilities," said Roberto
Garcia-Rodriguez, President and Chief Executive Officer.
"This has led to sustained membership momentum and premium growth
in a difficult environment, particularly in the government markets
sector. Continuing this momentum, we are delivering a very
competitive Medicare Advantage product for this year's open
enrollment period. Like most of our peer managed care
companies, we have also experienced lower than planned utilization
due to the impact of the ongoing pandemic.
"I am proud of our people, who continue to support our
customers, providers and communities. Through their efforts, we are
helping our members handle their medical needs safely and
partnering with our providers and community organizations to assist
our seniors and most vulnerable members during this challenging
time.
"As we look to 2021 and beyond, we aim to be the preeminent
healthcare company in Puerto Rico
by delivering seamless holistic care through innovative models,
state of the art technology and service excellence, in partnership
with our providers."
Third Quarter 2020 Consolidated Results and Other
Highlights
- Net income of $23.6 million, or
$1.02 per diluted share, versus net
income of $13.9 million, or
$0.58 per diluted share, in the
prior-year period;
- Adjusted net income of $14.2
million, or $0.61 per diluted
share, a 17.4% increase versus adjusted net income of $12.1 million, or $0.51 per diluted share, in the prior-year
period;
- Operating revenues of $942.9
million, a 12.8% increase from the prior-year period,
primarily reflecting higher Managed Care net premiums earned;
- Consolidated loss ratio of 82.5%, a 90 basis-point improvement
from the third quarter of 2019, reflecting higher premium rates and
lower utilization;
- Medical loss ratio ("MLR") of 84.7%, an improvement of 170
basis points over the same period last year;
- Consolidated operating income of $22.3
million, a 17.4% increase compared to $19.0 million in the prior-year period;
Selected Consolidated Quarterly Details
- Consolidated net premiums earned were $923.0 million, up 13.3% from the prior-year
period, primarily reflecting higher Managed Care premiums.
- Consolidated claims incurred were $761.8
million, up 12.0% year-over-year. Consolidated loss ratio
was 82.5%, 90 basis points lower than the prior-year period,
reflecting higher premium rates and lower utilization in the
Company's Managed Care segment.
- Consolidated operating expenses of $158.8 million increased by $21.9 million, or 16.0%, from the prior-year
period, primarily reflecting the reinstatement of the HIP fee in
2020 and expenses related to supplying much-needed assistance to
our providers, communities and seniors to help them manage through
the COVID-19 pandemic. The consolidated operating expense ratio was
17.1%, a 40 basis-point increase from the prior-year quarter.
Selected Segment Quarterly Details
Managed Care
- Managed Care premiums earned were $850.0
million, up 13.9% year-over-year.
-
- Medicare premiums earned of $400.7
million increased 9.2% from the prior-year period, largely
due to an increase of approximately 20,000 member months, which
primarily reflects a more competitive product offering and higher
premium rates due to an increase in the premium rate benchmark and
membership risk score. In addition, as utilization of services has
trended to almost-normalized levels, the Company reduced the
estimated MLR rebate accrual, which was originally recorded as a
reduction of premiums.
- Medicaid premiums earned of $240.9
million increased 36.6% from the prior-year period,
primarily reflecting higher member months of approximately 67,000,
higher average premium rates following three premium rate increases
effective November 1, 2019,
May 1, 2020 and July 1, 2020, and the reinstatement of the HIP
Fee pass-through in 2020.
- Commercial premiums earned of $208.4
million increased 2.6% from the prior-year period, mainly
reflecting higher average premium rates, an increase of
approximately 3,000 fully insured member months and the
reinstatement of the HIP Fee pass-through in 2020.
- Reported MLR of 84.7% improved 170 basis points from the
prior-year period, primarily reflecting higher average premium
rates and the reinstatement of the HIP Fee in 2020, as well as
lower utilization of services during the quarter as the result of
the pandemic, offset in part by increased benefits in the Medicare
product offering in 2020.
Life Insurance Segment
- Premiums earned of $50.1 million
increased 9.4% from the prior-year period, resulting from new sales
and the acquisition of a life insurance portfolio in the second
quarter of 2020.
- Operating income was $5.7
million, compared with $6.6
million in the prior year period, primarily caused by a
higher actuarial reserve due to the reinstatement of policies that
were cancelled during the second quarter of 2020 due to the
COVID-19 lockdown.
Property and Casualty Segment
- Premiums earned of $23.9 million
increased 0.8% from the prior-year period.
- Operating income was $4.4
million, compared with $6.6
million during the same quarter last year; this decrease was
primarily caused by an increase in net commission expense.
- Updated information related to Hurricane María as of
September 30, 2020:
-
- The Company's P&C subsidiary has paid a cumulative amount
of $767 million in claims and
expenses related to Hurricane María. Estimated gross losses remain
unchanged at $967 million.
- TSP closed 75 claims during the third quarter of 2020,
increasing the number of claims closed to 97.5%; 434 claims remain
open.
- The Company has been served with process with respect to 322 of
the 434 claims that remain open.
2020 Outlook
The Company is raising its full year 2020 guidance for adjusted
net income per diluted share to be between $3.25 and $3.35,
compared to its previous outlook for adjusted net income per
diluted share between $2.80 and
$3.00. The Company is currently
assuming a weighted average diluted share count for full year 2020
of 23.4 million shares.
Conference Call and Webcast
Management will host a conference call and webcast today at
8:30 a.m. Eastern Time to discuss its
financial results for the three months ended September 30, 2020. To participate, callers
within the U.S. and Canada should
dial 1-877-300-8521 and international callers should dial
1-412-317-6026 at least ten minutes before the call.
To listen to the webcast, participants should visit the
"Investor Relations" section of the Company's website at
www.triplesmanagement.com several minutes before the event is
broadcast and follow the instructions provided to ensure they have
the necessary audio application downloaded and installed. This
program is provided at no charge to the user. An archived version
of the call, also located on the "Investor Relations" section of
Triple-S Management's website, will be available about two hours
after the call ends for one year. This news release, along with
other information relating to the call, will be available on the
"Investor Relations" section of the website.
About Triple-S Management Corporation
Triple-S Management Corporation is a healthcare company and one
of the top players in the Puerto
Rico healthcare industry, with over 60 years of
experience as the premier brand serving more people through
the most attractive provider networks on the island. We have
the exclusive right to use the Blue Cross Blue Shield name and mark
throughout Puerto Rico, the
U.S. Virgin Islands, Costa Rica, the British Virgin Islands and Anguilla, and we offer a broad portfolio of
managed care and related products in the Commercial, Medicare
Advantage and Medicaid markets. Triple-S is also a well-known brand
in the life insurance and property and casualty insurance markets
in Puerto Rico, with strong
customer relationships and a significant market share. For more
information about Triple-S Management, visit
www.triplesmanagement.com or contact
investorrelations@ssspr.com.
Non-GAAP Financial Measures
This earnings release presents information about the Company's
adjusted net income, which is a non-GAAP financial metric provided
as a complement to the results provided in accordance with
accounting principles generally accepted in the United States of America (GAAP). A
reconciliation of adjusted net income to net income, the most
comparable GAAP financial measure, is provided in the accompanying
tables found at the end of this release.
Forward-Looking Statements
This document contains forward-looking statements, as defined in
the Private Securities Litigation Reform Act of 1995.
Forward-looking statements include information about possible or
assumed future sales, results of operations, developments,
regulatory approvals or other circumstances. Sentences that include
"believe", "expect", "plan", "intend", "estimate", "anticipate",
"project", "may", "will", "shall", "should" and similar
expressions, whether in the positive or negative, are intended to
identify forward-looking statements.
All forward-looking statements in this news release reflect
management's current views about future events and are based on
assumptions and subject to risks and uncertainties. Consequently,
actual results may differ materially from those expressed here as a
result of various factors, including all the risks discussed and
identified in public filings with the U.S. Securities and Exchange
Commission (SEC).
In addition, the Company operates in a highly competitive,
constantly changing environment, influenced by very large
organizations that have resulted from business combinations,
aggressive marketing and pricing practices of competitors, and
regulatory oversight. The following factors, if markedly different
from the Company's planning assumptions (either individually or in
combination), could cause Triple-S Management's results to differ
materially from those expressed in any forward-looking statements
shared here:
- Trends in health care costs and utilization rates
- Ability to secure sufficient premium rate increases
- Competitor pricing below market trends of increasing costs
- Re-estimates of policy and contract liabilities and
reserves
- Changes in government laws and regulations of managed care,
life insurance or property and casualty insurance
- Significant acquisitions or divestitures by major
competitors
- Introduction and use of new prescription drugs and
technologies
- A downgrade in the Company's financial strength ratings
- Litigation or legislation targeted at managed care, life
insurance or property and casualty insurance companies
- Ability to contract with providers consistent with past
practice
- Ability to successfully implement the Company's disease
management, utilization management and Star ratings programs
- Ability to maintain Federal Employees, Medicare and Medicaid
contracts
- Volatility in the securities markets and investment losses and
defaults
- General economic downturns, major disasters, and epidemics
This list is not exhaustive. Management believes the
forward-looking statements in this release are reasonable. However,
there is no assurance that the actions, events or results
anticipated by the forward-looking statements will occur or, if any
of them do, what impact they will have on the Company's results of
operations or financial condition. In view of these uncertainties,
investors should not place undue reliance on any forward-looking
statements, which are based on current expectations. In addition,
forward-looking statements are based on information available the
day they are made, and (other than as required by applicable law,
including the securities laws of the
United States) the Company does not intend to update or
revise any of them in light of new information or future
events.
Readers are advised to carefully review and consider the various
disclosures in the Company's SEC reports.
Earnings Release
Schedules and Supplemental Information
|
Condensed
Consolidated Balance
Sheets..................................................................................
Exhibit I
|
Condensed
Consolidated Statements of
Earnings.....................................................................
Exhibit II
|
Condensed
Consolidated Statements of Cash
Flows................................................................
Exhibit III
|
Segment Performance
Supplemental
Information.....................................................................
Exhibit IV
|
Reconciliation of
Non-GAAP Financial
Measures.......................................................................
Exhibit V
|
Exhibit
I
|
|
Condensed
Consolidated Balance Sheets
|
(dollar amounts in
thousands)
|
Unaudited
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
September 30,
2020
|
|
December 31,
2019
|
Assets
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Investments
|
|
$
|
1,874,331
|
|
$
|
1,643,637
|
Cash and cash
equivalents
|
|
|
129,603
|
|
|
109,837
|
Premium and other
receivables, net
|
|
|
546,959
|
|
|
567,692
|
Deferred policy
acquisition costs and value of business acquired
|
|
243,663
|
|
|
234,885
|
Property and
equipment, net
|
|
|
130,220
|
|
|
88,588
|
Other
assets
|
|
|
195,511
|
|
|
174,187
|
|
|
|
|
|
|
|
|
|
|
|
|
Total
assets
|
|
$
|
3,120,287
|
|
$
|
2,818,826
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Liabilities and
Stockholders' Equity
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Policy liabilities
and accruals
|
|
$
|
1,551,181
|
|
$
|
1,425,477
|
Accounts payable and
accrued liabilities
|
|
|
423,083
|
|
|
370,483
|
Short-term
borrowings
|
|
|
82,500
|
|
|
54,000
|
Long-term
borrowings
|
|
|
53,836
|
|
|
25,694
|
|
|
|
|
|
|
|
|
|
|
|
|
Total
liabilities
|
|
|
2,110,600
|
|
|
1,875,654
|
|
|
|
|
|
|
|
|
|
|
Stockholders'
equity:
|
|
|
|
|
|
|
|
Common
stock
|
|
|
23,430
|
|
|
23,800
|
|
Other stockholders'
equity
|
|
|
986,970
|
|
|
920,065
|
|
|
|
|
|
|
|
|
|
|
|
|
Total Triple-S
Management Corporation stockholders' equity
|
|
1,010,400
|
|
|
943,865
|
|
|
|
|
|
|
|
|
|
|
|
|
Non-controlling
interest in consolidated subsidiary
|
|
|
(713)
|
|
|
(693)
|
|
|
|
|
|
|
|
|
|
|
|
|
Total stockholders'
equity
|
|
|
1,009,687
|
|
|
943,172
|
|
|
|
|
|
|
|
|
|
|
|
|
Total liabilities and
stockholders' equity
|
|
$
|
3,120,287
|
|
$
|
2,818,826
|
Exhibit
II
|
|
Condensed
Consolidated Statements of Earnings
|
(dollar amounts in
thousands, except per share data)
|
Unaudited
|
|
|
|
|
|
|
|
|
|
For the Three
Months Ended
|
|
For the Nine
Months Ended
|
|
|
|
|
|
|
|
|
September
30,
|
|
September
30,
|
|
|
|
|
|
|
|
|
2020
|
|
2019
|
|
2020
|
|
2019
|
Revenues:
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Premiums earned,
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 the 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
|
|
$
|
1.02
|
|
$
|
0.59
|
|
$
|
1.77
|
|
$
|
3.44
|
|
Diluted net income
per share
|
|
$
|
1.02
|
|
$
|
0.58
|
|
$
|
1.76
|
|
$
|
3.43
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Weighted average of
common shares
|
|
|
23,073,511
|
|
|
23,830,106
|
|
|
23,215,840
|
|
|
23,143,361
|
|
Diluted weighted
average of common shares
|
|
|
23,193,980
|
|
|
23,893,807
|
|
|
23,318,069
|
|
|
23,217,298
|
Exhibit
III
|
|
Condensed
Consolidated Statements of Cash Flows
|
(dollar amounts in
thousands)
|
Unaudited
|
|
|
|
|
|
|
|
|
For the Nine
Months Ended
|
|
|
|
|
|
|
|
September
30,
|
|
|
|
|
|
|
|
2020
|
|
2019
|
|
|
|
|
|
|
|
|
|
|
|
|
Net cash provided by
(used in) operating activities
|
|
$
|
223,681
|
|
$
|
(3,455)
|
|
|
|
|
|
|
|
|
|
|
Cash flows from
investing activities:
|
|
|
|
|
|
|
|
Proceeds from
investments sold or matured:
|
|
|
|
|
|
|
|
|
Securities available
for sale:
|
|
|
|
|
|
|
|
|
|
Fixed maturities
sold
|
|
|
94,557
|
|
|
365,383
|
|
|
|
Fixed maturities
matured/called
|
|
|
37,450
|
|
|
19,017
|
|
|
Securities held to
maturity - fixed maturities matured/called
|
|
|
1,079
|
|
|
1,378
|
|
|
Equity investments
sold
|
|
|
80,152
|
|
|
126,134
|
|
|
Other invested assets
sold
|
|
|
13,231
|
|
|
3,379
|
|
Acquisition of
investments:
|
|
|
|
|
|
|
|
|
Securities available
for sale - fixed maturities
|
|
|
(206,387)
|
|
|
(397,956)
|
|
|
Securities held to
maturity - fixed maturities
|
|
|
(1,087)
|
|
|
(748)
|
|
|
Equity
investments
|
|
|
(201,324)
|
|
|
(88,945)
|
|
|
Other invested
assets
|
|
|
(25,442)
|
|
|
(24,233)
|
|
Increase in other
investments
|
|
|
(3,924)
|
|
|
(2,710)
|
|
Net change in policy
loans
|
|
|
240
|
|
|
(1,097)
|
|
Net capital
expenditures
|
|
|
(52,549)
|
|
|
(14,746)
|
|
Capital contribution
on equity method investees
|
|
|
(7,083)
|
|
|
-
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Net cash used in
investing activities
|
|
|
(271,087)
|
|
|
(15,144)
|
|
|
|
|
|
|
|
|
|
|
Cash flows from
financing activities:
|
|
|
|
|
|
|
|
Change in outstanding
checks in excess of bank balances
|
|
|
16,814
|
|
|
3,808
|
|
Net change in
short-term borrowings
|
|
|
28,500
|
|
|
-
|
|
Proceeds of long-term
borrowings
|
|
|
30,841
|
|
|
-
|
|
Repayments of
long-term borrowings
|
|
|
(2,760)
|
|
|
(2,425)
|
|
Repurchase and
retirement of common stock
|
|
|
(14,980)
|
|
|
(1)
|
|
Proceeds from
policyholder deposits
|
|
|
21,586
|
|
|
15,060
|
|
Surrender of
policyholder deposits
|
|
|
(12,829)
|
|
|
(16,455)
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Net cash provided by
(used in) financing activities
|
|
|
67,172
|
|
|
(13)
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Net increase
(decrease) in cash and cash equivalents
|
|
|
19,766
|
|
|
(18,612)
|
|
|
|
|
|
|
|
|
|
|
|
|
Cash and cash
equivalents, beginning of period
|
|
|
109,837
|
|
|
117,544
|
|
|
|
|
|
|
|
|
|
|
Cash and cash
equivalents, end of period
|
|
$
|
129,603
|
|
$
|
98,932
|
Exhibit
IV
|
|
Segment
Performance Supplemental Information
|
|
(Unaudited)
|
|
Three months ended
September 30,
|
|
Nine months ended
September 30,
|
(dollar amounts in
millions)
|
2020
|
2019
|
Percentage
Change
|
|
2020
|
2019
|
Percentage
Change
|
Premiums earned,
net:
|
|
|
|
|
|
|
|
|
Managed
Care:
|
|
|
|
|
|
|
|
|
|
Commercial
|
$
208.4
|
$
203.1
|
2.6%
|
|
$
605.3
|
$
602.4
|
0.5%
|
|
|
Medicare
|
400.7
|
367.1
|
9.2%
|
|
1,160.9
|
1,065.7
|
8.9%
|
|
|
Medicaid
|
240.9
|
176.3
|
36.6%
|
|
682.9
|
577.7
|
18.2%
|
|
|
|
Total Managed
Care
|
850.0
|
746.5
|
13.9%
|
|
2,449.1
|
2,245.8
|
9.1%
|
|
Life
Insurance
|
50.1
|
45.8
|
9.4%
|
|
144.9
|
135.1
|
7.3%
|
|
Property and
Casualty
|
23.9
|
23.7
|
0.8%
|
|
66.9
|
64.9
|
3.1%
|
|
Other
|
|
|
(1.0)
|
(1.0)
|
0.0%
|
|
(3.5)
|
(3.3)
|
(6.1%)
|
|
|
|
|
Consolidated premiums
earned, net
|
$
923.0
|
$
815.0
|
13.3%
|
|
$
2,657.4
|
$
2,442.5
|
8.8%
|
Operating revenues:
1
|
|
|
|
|
|
|
|
|
Managed
Care
|
$
858.2
|
$
755.8
|
13.5%
|
|
$
2,473.7
|
$
2,273.7
|
8.8%
|
|
Life
Insurance
|
57.0
|
52.5
|
8.6%
|
|
165.5
|
155.1
|
6.7%
|
|
Property and
Casualty
|
26.1
|
26.2
|
(0.4%)
|
|
73.5
|
72.3
|
1.7%
|
|
Other
|
|
|
1.6
|
1.4
|
14.3%
|
|
2.1
|
1.0
|
110.0%
|
|
|
|
|
Consolidated
operating revenues
|
$
942.9
|
$
835.9
|
12.8%
|
|
$
2,714.8
|
$
2,502.1
|
8.5%
|
Operating income
(loss): 2
|
|
|
|
|
|
|
|
|
Managed
Care
|
$
13.0
|
$
5.4
|
140.7%
|
|
$
56.5
|
$
56.8
|
(0.5%)
|
|
Life
Insurance
|
5.7
|
6.6
|
(13.6%)
|
|
20.2
|
17.5
|
15.4%
|
|
Property and
Casualty
|
4.4
|
6.6
|
(33.3%)
|
|
10.9
|
14.9
|
(26.8%)
|
|
Other
|
|
|
(0.8)
|
0.4
|
(300.0%)
|
|
(1.9)
|
(0.2)
|
(850.0%)
|
|
|
|
|
Consolidated
operating income
|
$
22.3
|
$
19.0
|
17.4%
|
|
$
85.7
|
$
89.0
|
(3.7%)
|
Operating margin:
3
|
|
|
|
|
|
|
|
|
Managed
Care
|
1.5%
|
0.7%
|
80 bp
|
|
2.3%
|
2.5%
|
-20 bp
|
|
Life
Insurance
|
10.0%
|
12.6%
|
-260 bp
|
|
12.2%
|
11.3%
|
90 bp
|
|
Property and
Casualty
|
16.9%
|
25.2%
|
-830 bp
|
|
14.8%
|
20.6%
|
-580 bp
|
|
Consolidated
|
2.4%
|
2.3%
|
10 bp
|
|
3.2%
|
3.6%
|
-40 bp
|
Depreciation and
amortization expense
|
$
3.1
|
$
3.7
|
(16.2%)
|
|
$
10.9
|
$
10.7
|
1.9%
|
|
1 Operating revenues include premiums
earned, net, administrative service fees and net investment
income.
|
2 Operating income or loss include
operating revenues minus operating costs. Operating costs include
claims incurred and operating expenses.
|
3 Operating margin is defined as
operating income or loss divided by operating revenues.
|
Managed Care
Additional Data
|
|
|
|
|
|
|
|
Three months
ended
September 30,
|
|
Nine months
ended
September 30,
|
(Unaudited)
|
|
2020
|
2019
|
|
2020
|
2019
|
Member months
enrollment:
|
|
|
|
|
|
|
Commercial:
|
|
|
|
|
|
|
|
Fully-insured
|
966,906
|
964,321
|
|
2,920,460
|
2,872,836
|
|
|
Self-insured
|
324,372
|
356,059
|
|
981,634
|
1,072,510
|
|
|
|
Total
Commercial
|
1,291,278
|
1,320,380
|
|
3,902,094
|
3,945,346
|
|
Medicare
Advantage
|
|
|
|
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
|
Claim liabilities
(in millions)
|
|
|
|
$
420.6
|
$
390.3
|
Days claim
payable
|
|
|
|
57
|
56
|
Premium
PMPM:
|
|
|
|
|
|
|
Managed
Care
|
$
339.09
|
$
308.83
|
|
$
330.12
|
$
311.18
|
|
|
Commercial
|
215.53
|
210.61
|
|
207.26
|
209.69
|
|
|
Medicare
Advantage
|
984.11
|
948.59
|
|
951.34
|
921.54
|
|
|
Medicaid
|
212.69
|
165.40
|
|
208.32
|
181.22
|
Medical loss
ratio:
|
84.7%
|
86.4%
|
|
82.7%
|
84.9%
|
|
Commercial
|
81.9%
|
84.7%
|
|
76.1%
|
82.8%
|
|
Medicare
Advantage
|
80.6%
|
81.1%
|
|
80.2%
|
81.4%
|
|
Medicaid
|
|
94.0%
|
99.6%
|
|
92.7%
|
93.4%
|
Adjusted medical loss
ratio: 1
|
82.1%
|
89.4%
|
|
81.3%
|
86.5%
|
|
Commercial
|
78.3%
|
88.5%
|
|
74.9%
|
85.1%
|
|
Medicare
Advantage
|
78.4%
|
81.6%
|
|
78.9%
|
80.9%
|
|
Medicaid
|
|
91.7%
|
104.9%
|
|
91.0%
|
97.2%
|
Operating expense
ratio:
|
|
|
|
|
|
|
Consolidated
|
17.1%
|
16.7%
|
|
18.7%
|
16.5%
|
|
Managed
Care
|
14.6%
|
14.0%
|
|
15.9%
|
13.8%
|
|
1 The
adjusted medical loss ratio accounts for subsequent adjustments to
estimates, such as prior-period reserve developments and Medicare
premium adjustments, and presents them in their corresponding
period.
|
Managed Care
Membership by Segment
|
|
Managed Care
Membership by Segment
|
As of September
30,
|
|
2020
|
2019
|
Members:
|
|
|
Commercial:
|
|
|
Fully-insured
|
321,673
|
322,992
|
Self-insured
|
107,830
|
119,077
|
Total
Commercial
|
429,503
|
442,069
|
Medicare
Advantage
|
136,135
|
128,660
|
Medicaid
|
385,344
|
354,230
|
Total
members
|
950,982
|
924,959
|
Exhibit
V
|
|
Reconciliation of
Non-GAAP Financial Measures
|
|
|
Adjusted Net
Income
|
(Unaudited)
|
|
Three months
ended
September 30,
|
Nine months
ended
September 30,
|
(dollar amounts in
millions, except per share data)
|
2020
|
2019
|
|
2020
|
2019
|
Net income
|
|
$
23.6
|
$
13.9
|
|
$
41.0
|
$
79.7
|
Less adjustments, net
of taxes:
|
|
|
|
|
|
|
Net realized
investment gains (losses)
|
0.4
|
0.9
|
|
(0.1)
|
3.8
|
|
Unrealized gains
(losses) on equity investments
|
8.8
|
1.0
|
|
(13.9)
|
19.4
|
|
Contingency
accrual
|
-
|
-
|
|
(20.0)
|
-
|
|
Private equity
investment income (loss)
|
0.2
|
(0.1)
|
|
2.4
|
1.0
|
|
|
Adjusted net
income
|
$
14.2
|
$
12.1
|
|
$
72.6
|
$
55.6
|
|
|
Diluted adjusted net
income per share
|
$
0.61
|
$
0.51
|
|
$
3.12
|
$
2.39
|
Adjusted net income is a non-GAAP financial metric and should
not be considered a substitute for, or superior to, financial
measures calculated in accordance with GAAP. Management
believes that the use of this adjusted net income and adjusted net
income per share provides investors and management useful
information about the earnings impact of realized and unrealized
investment gains or losses, as well as other non-recurring items
impacting the Company's results of operations. This non-GAAP
metric does not consider all the items associated with the
Company's operations as determined in accordance with GAAP.
As a result, one should not consider these measures in
isolation.
FOR FURTHER
INFORMATION:
|
|
|
|
AT THE
COMPANY:
|
INVESTOR
RELATIONS:
|
Juan José
Román-Jiménez
|
Mr. Garrett
Edson
|
EVP and Chief
Financial Officer
|
ICR
|
(787)
749-4949
|
(787)
792-6488
|
View original content to download
multimedia:http://www.prnewswire.com/news-releases/triple-s-management-corporation-reports-third-quarter-2020-results-301167673.html
SOURCE Triple-S Management Corporation