SAN JUAN, Puerto Rico,
Nov. 4, 2021 /PRNewswire/
-- Triple-S Management Corporation (NYSE:GTS), a leading
healthcare services company in Puerto
Rico, today announced its third quarter 2021 results.
Roberto Garcia-Rodriguez,
President and Chief Executive Officer, commented: "We had a solid
third quarter performance as we continued to record double-digit
revenue growth year-over-year, driven by our Medicaid offering
along with solid growth at our Life and P&C segments.
Moving forward, we continue to progress in our integrated
healthcare strategy, enabling us to deliver additional attractive
products, along with the high-quality care and superior service to
which our members have become accustomed."
Third Quarter 2021 Consolidated Results and Other
Highlights
- Net income of $8.2 million, or
$0.35 per diluted share, compared
with $23.6 million, or $1.02 per diluted share, in the prior year
period.
- Adjusted net income of $9.6
million, or $0.41 per diluted
share, versus $14.2 million, or
$0.61 per diluted share, in the
prior-year period.
- Operating revenue of $1.0
billion, a 10.8% increase from the prior-year period,
primarily reflecting higher Managed Care net premiums earned.
- Consolidated loss ratio of 86.2%, an increase of 370 basis
points compared with the third quarter of 2020, reflecting
normalized Managed Care utilization patterns in the third quarter
of 2021.
- Medical loss ratio (MLR) of 88.7%, 400 basis points higher than
the same period last year.
- Consolidated operating income of $11.5
million, compared with $22.3
million in the prior-year period.
Selected Segment Quarterly Details
Managed Care
- Managed Care premiums earned were $939.7
million, up 10.6% year-over-year.
-
- Medicare premiums earned were $423.1
million, an increase of 5.6% from the prior-year period. The
increase was largely due to higher premium rates resulting from a
rise in the premium rate benchmark and membership risk score and
higher enrollment.
- Medicaid premiums earned were $302.2
million, an increase of 25.4% from the prior-year period,
primarily reflecting an increase in enrollment of approximately
210,000 member months and higher average premium rates. In
addition, following a reconciliation process with ASES this
quarter, the Company recognized premiums corresponding to prior
periods. These increases were partially offset by the elimination
of the HIP fee pass-through in 2021.
- Commercial premiums earned were $214.4
million, an increase of 2.9% from the prior-year period,
mainly reflecting higher average premium rates in the 2021 period,
partially offset by the elimination of the HIP fee pass-through in
2021.
- Reported MLR was 88.7%, an increase of 400 basis points from
the prior-year period, primarily reflecting the elimination of the
HIP fee in 2021, normalized utilization of services compared with
the low utilization in the prior-year quarter due to the pandemic,
higher costs associated with COVID-19-related testing, treatment
costs and the waiver of medical and payment policies, and increased
benefits in the Medicare product offering in 2021.
- Managed Care operating expenses were $109.4 million, a decrease of $15.5 million, or 12.4%, from the prior-year
quarter, primarily reflecting the elimination of the HIP fee in
2021 and lower business promotion expenses, partially offset by
higher personnel costs. The segment operating expense ratio was
11.6%, a 300 basis-point improvement from the prior-year
quarter.
Life Insurance Segment
- Premiums earned, net were $55.1
million, a 10.0% increase from the prior-year period,
resulting from higher sales across all lines of business,
particularly in the Individual Life and Cancer lines of business.
Operating income was $5.6 million,
compared to $5.7 million in the
prior-year period.
Property and Casualty Segment
- Premiums earned, net were $26.3
million, an increase of 10.0% from the prior-year period.
The increase was primarily due to higher premiums in Personal
Package, Commercial Liability, Commercial Auto and Commercial
Property products, partially offset by a decrease in Commercial
Package products.
- Operating income was $2.0
million, compared with $4.4
million in the prior-year period, primarily driven by higher
losses and operating expenses in the 2021 quarter. Losses during
the 2020 period were lower due to the COVID-19 pandemic.
Liquidity and Capital Resources
- As of September 30, 2021, the
Company had cash and cash equivalents of $122.7 million and investments of $1.9 billion on its consolidated balance
sheet.
2021 Outlook and Conference Call
Due to the pending transaction with GuideWell Mutual Holding
Corporation announced on August 24,
2021, the Company will not be hosting a conference call or
providing an updated outlook for the fourth quarter or full year
2021. The Company's previously issued full year 2021 outlook should
no longer be relied upon. Please visit the Investor Relations
section of the Company's website at
http://investors.triplesmanagement.com for the latest releases
and information.
About Triple-S Management Corporation
Triple-S Management, a health services company, serves more than
1 million customers in Puerto
Rico, which represents nearly one-third of the island's
population. With over 60 years of experience, it is the premier
insurance and managed care brand, with the largest customer base
and broadest provider networks on the island. Triple-S Management
has 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 offers a broad portfolio of
managed care and related products in the commercial, Medicare
Advantage and Medicaid segments. Triple-S Management is also a
well-known brand in the life insurance and property and casualty
insurance segments 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 and government agencies
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 in
thousands)
|
|
Unaudited
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
September 30,
2021
|
|
December 31,
2020
|
|
Assets
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Investments
|
|
$
|
1,940,745
|
|
$
|
1,874,024
|
|
Cash and cash
equivalents
|
|
|
122,709
|
|
|
110,989
|
|
Premium and other
receivables, net
|
|
|
496,477
|
|
|
488,840
|
|
Deferred policy
acquisition costs and value of business acquired
|
|
255,010
|
|
|
248,325
|
|
Property and
equipment, net
|
|
|
137,762
|
|
|
131,974
|
|
Other
assets
|
|
|
238,963
|
|
|
234,266
|
|
|
|
|
|
|
|
|
|
|
|
|
Total
assets
|
|
$
|
3,191,666
|
|
$
|
3,088,418
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Liabilities and
Stockholders' Equity
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Policy liabilities
and accruals
|
|
$
|
1,588,117
|
|
$
|
1,550,798
|
|
Accounts payable and
accrued liabilities
|
|
|
537,110
|
|
|
487,356
|
|
Short-term
borrowings
|
|
|
-
|
|
|
30,000
|
|
Long-term
borrowings
|
|
|
49,498
|
|
|
52,751
|
|
|
|
|
|
|
|
|
|
|
|
|
Total
liabilities
|
|
|
2,174,725
|
|
|
2,120,905
|
|
|
|
|
|
|
|
|
|
|
|
Stockholders'
equity:
|
|
|
|
|
|
|
|
Common
stock
|
|
|
23,795
|
|
|
23,430
|
|
Other stockholders'
equity
|
|
|
993,879
|
|
|
944,800
|
|
|
|
|
|
|
|
|
|
|
|
|
Total Triple-S
Management Corporation stockholders' equity
|
|
1,017,674
|
|
|
968,230
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Non-controlling
interest in consolidated subsidiary
|
|
|
(733)
|
|
|
(717)
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Total stockholders'
equity
|
|
|
1,016,941
|
|
|
967,513
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Total liabilities and
stockholders' equity
|
|
$
|
3,191,666
|
|
$
|
3,088,418
|
|
Exhibit
II
|
|
|
Condensed
Consolidated Statements of Earnings
|
|
(dollar in thousands,
except per share information)
|
|
Unaudited
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
For the Three
Months Ended
|
|
For the Nine
Months Ended
|
|
|
|
|
|
|
|
|
September
30,
|
|
September
30,
|
|
|
|
|
|
|
|
|
2021
|
|
2020
|
|
2021
|
|
2020
|
|
Revenues
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Premiums earned,
net
|
|
$
|
1,019,696
|
|
$
|
922,934
|
|
$
|
3,016,012
|
|
$
|
2,657,366
|
|
Administrative
service fees
|
|
|
3,875
|
|
|
3,752
|
|
|
9,316
|
|
|
8,755
|
|
Net investment
income
|
|
|
17,572
|
|
|
14,168
|
|
|
46,178
|
|
|
42,294
|
|
Other operating
revenues
|
|
|
3,925
|
|
|
2,052
|
|
|
8,518
|
|
|
6,394
|
|
|
Total operating
revenues
|
|
|
1,045,068
|
|
|
942,906
|
|
|
3,080,024
|
|
|
2,714,809
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Net realized
investment gains (losses)
|
|
|
1,015
|
|
|
507
|
|
|
3,746
|
|
|
(180)
|
|
Net unrealized
investment (losses) gains on equity investments
|
|
|
(7,912)
|
|
|
11,040
|
|
|
13,383
|
|
|
(17,428)
|
|
Other income,
net
|
|
|
11,085
|
|
|
1,811
|
|
|
19,047
|
|
|
6,217
|
|
|
Total
revenues
|
|
|
1,049,256
|
|
|
956,264
|
|
|
3,116,200
|
|
|
2,703,418
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Benefits and
expenses
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Claims incurred, net
of reinsurance
|
|
|
878,947
|
|
|
761,792
|
|
|
2,573,569
|
|
|
2,129,401
|
|
Operating
expenses
|
|
|
154,526
|
|
|
158,809
|
|
|
456,880
|
|
|
499,669
|
|
|
Total operating
costs
|
|
|
1,033,473
|
|
|
920,601
|
|
|
3,030,449
|
|
|
2,629,070
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Interest
expense
|
|
|
2,016
|
|
|
2,096
|
|
|
6,225
|
|
|
5,813
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Total benefits and
expenses
|
|
|
1,035,489
|
|
|
922,697
|
|
|
3,036,674
|
|
|
2,634,883
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Income before
taxes
|
|
|
13,767
|
|
|
33,567
|
|
|
79,526
|
|
|
68,535
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Income tax
expense
|
|
|
5,607
|
|
|
9,989
|
|
|
24,505
|
|
|
27,520
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Net income
|
|
|
|
|
|
8,160
|
|
|
23,578
|
|
|
55,021
|
|
|
41,015
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Net loss attributable
to the non-controlling interest
|
|
|
7
|
|
|
3
|
|
|
16
|
|
|
20
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Net income
attributable to Triple-S Management Corporation
|
|
$
|
8,167
|
|
$
|
23,581
|
|
$
|
55,037
|
|
$
|
41,035
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Earnings per share
attributable to Triple-S Management Corporation:
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Basic net income per
share
|
|
$
|
0.35
|
|
$
|
1.02
|
|
$
|
2.35
|
|
$
|
1.77
|
|
Diluted net income
per share
|
|
$
|
0.35
|
|
$
|
1.02
|
|
$
|
2.34
|
|
$
|
1.76
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Weighted average of
common shares
|
|
|
23,494,415
|
|
|
23,073,511
|
|
|
23,402,622
|
|
|
23,215,840
|
|
Diluted weighted
average of common shares
|
|
|
23,610,672
|
|
|
23,193,980
|
|
|
23,546,277
|
|
|
23,318,069
|
|
Exhibit
III
|
|
|
Condensed
Consolidated Statements of Cash Flows
|
|
(dollar in
thousands)
|
|
Unaudited
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
For the Nine
Months Ended
|
|
|
|
|
|
|
|
September
30,
|
|
|
|
|
|
|
|
2021
|
|
2020
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Net cash provided by
operating activities
|
|
$
|
100,699
|
|
$
|
223,681
|
|
|
|
|
|
|
|
|
|
|
|
Cash flows from
investing activities:
|
|
|
|
|
|
|
|
Proceeds from
investments sold or matured:
|
|
|
|
|
|
|
|
|
Securities
available-for-sale:
|
|
|
|
|
|
|
|
|
|
Fixed-maturities
sold
|
|
|
140,866
|
|
|
94,557
|
|
|
|
Fixed-maturities
matured/called
|
|
|
18,271
|
|
|
37,450
|
|
|
Securities
held-to-maturity - fixed-maturities matured/called
|
|
|
747
|
|
|
1,079
|
|
|
Equity investments
sold
|
|
|
99,951
|
|
|
80,152
|
|
|
Other invested assets
sold
|
|
|
19,652
|
|
|
13,231
|
|
Acquisition of
investments:
|
|
|
|
|
|
|
|
|
Securities
available-for-sale - fixed-maturities
|
|
|
(129,066)
|
|
|
(206,387)
|
|
|
Securities
held-to-maturity - fixed-maturities
|
|
|
(751)
|
|
|
(1,087)
|
|
|
Equity
investments
|
|
|
(199,046)
|
|
|
(201,324)
|
|
|
Other invested
assets
|
|
|
(9,317)
|
|
|
(25,442)
|
|
(Decrease) increase
in other investments
|
|
|
(4,470)
|
|
|
(3,924)
|
|
Net change in policy
loans
|
|
|
(21)
|
|
|
240
|
|
Net capital
expenditures
|
|
|
(16,948)
|
|
|
(52,549)
|
|
Capital contribution
on equity method investees
|
|
|
-
|
|
|
(7,083)
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Net cash used in
investing activities
|
|
|
(80,132)
|
|
|
(271,087)
|
|
|
|
|
|
|
|
|
|
|
|
Cash flows from
financing activities:
|
|
|
|
|
|
|
|
Change in outstanding
checks in excess of bank balances
|
|
|
20,594
|
|
|
16,814
|
|
Net change in
short-term borrowings
|
|
|
(30,000)
|
|
|
28,500
|
|
Proceeds of long-term
borrowings
|
|
|
-
|
|
|
30,841
|
|
Repayments of
long-term borrowings
|
|
|
(3,370)
|
|
|
(2,760)
|
|
Repurchase and
retirement of common stock
|
|
|
-
|
|
|
(14,980)
|
|
Proceeds from
policyholder deposits
|
|
|
12,594
|
|
|
21,586
|
|
Surrender of
policyholder deposits
|
|
|
(8,665)
|
|
|
(12,829)
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Net cash (used in)
provided by financing activities
|
|
|
(8,847)
|
|
|
67,172
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Net increase in cash
and cash equivalents
|
|
|
11,720
|
|
|
19,766
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Cash and cash
equivalents, beginning of period
|
|
|
110,989
|
|
|
109,837
|
|
|
|
|
|
|
|
|
|
|
|
Cash and cash
equivalents, end of period
|
|
$
|
122,709
|
|
$
|
129,603
|
|
Exhibit
IV
|
|
|
Segment
Performance Supplemental Information
|
|
|
(Unaudited)
|
|
Three months ended
September 30,
|
|
Nine months ended
September 30,
|
|
(dollar in
millions)
|
2021
|
2020
|
Percentage
Change
|
|
2021
|
2020
|
Percentage
Change
|
|
Premiums earned,
net:
|
|
|
|
|
|
|
|
|
Managed
Care:
|
|
|
|
|
|
|
|
|
|
Medicare
|
$
423.1
|
$
400.7
|
5.6%
|
|
$
1,233.8
|
$
1,160.9
|
6.3%
|
|
|
Medicaid
|
302.2
|
240.9
|
25.4%
|
|
916.7
|
682.9
|
34.2%
|
|
|
Commercial
|
214.4
|
208.4
|
2.9%
|
|
631.0
|
605.3
|
4.2%
|
|
|
|
Total Managed
Care
|
939.7
|
850.0
|
10.6%
|
|
2,781.5
|
2,449.1
|
13.6%
|
|
Life
Insurance
|
55.1
|
50.1
|
10.0%
|
|
161.6
|
144.9
|
11.5%
|
|
Property and
Casualty
|
26.3
|
23.9
|
10.0%
|
|
76.9
|
66.9
|
14.9%
|
|
Other
|
|
|
(1.4)
|
(1.0)
|
(40.0%)
|
|
(4.0)
|
(3.5)
|
(14.3%)
|
|
|
|
|
Consolidated premiums
earned, net
|
$
1,019.7
|
$
923.0
|
10.5%
|
|
$
3,016.0
|
$
2,657.4
|
13.5%
|
|
Operating revenues:
1
|
|
|
|
|
|
|
|
|
Managed
Care
|
$
951.7
|
$
858.2
|
10.9%
|
|
$
2,810.6
|
$
2,473.7
|
13.6%
|
|
Life
Insurance
|
61.9
|
57.0
|
8.6%
|
|
181.5
|
165.5
|
9.7%
|
|
Property and
Casualty
|
28.8
|
26.1
|
10.3%
|
|
83.7
|
73.5
|
13.9%
|
|
Other
|
|
|
2.6
|
1.6
|
62.5%
|
|
4.2
|
2.1
|
100.0%
|
|
|
|
|
Consolidated
operating revenues
|
$
1,045.0
|
$
942.9
|
10.8%
|
|
$
3,080.0
|
$
2,714.8
|
13.5%
|
|
Operating income
(loss): 2
|
|
|
|
|
|
|
|
|
Managed
Care
|
$
8.5
|
$
13.0
|
(34.6%)
|
|
$
34.5
|
$
56.5
|
(38.9%)
|
|
Life
Insurance
|
5.6
|
5.7
|
(1.8%)
|
|
17.8
|
20.2
|
(11.9%)
|
|
Property and
Casualty
|
2.0
|
4.4
|
(54.5%)
|
|
7.8
|
10.9
|
(28.4%)
|
|
Other
|
|
|
(4.6)
|
(0.8)
|
(475.0%)
|
|
(10.6)
|
(1.9)
|
(457.9%)
|
|
|
|
|
Consolidated
operating income
|
$
11.5
|
$
22.3
|
(48.4%)
|
|
$
49.5
|
$
85.7
|
(42.2%)
|
|
Operating margin:
3
|
|
|
|
|
|
|
|
|
Managed
Care
|
0.9%
|
1.5%
|
-60 bp
|
|
1.2%
|
2.3%
|
-110 bp
|
|
Life
Insurance
|
9.0%
|
10.0%
|
-100 bp
|
|
9.8%
|
12.2%
|
-240 bp
|
|
Property and
Casualty
|
6.9%
|
16.9%
|
-1,000 bp
|
|
9.3%
|
14.8%
|
-550 bp
|
|
Consolidated
|
1.1%
|
2.4%
|
-130 bp
|
|
1.6%
|
3.2%
|
-160 bp
|
|
Depreciation and
amortization expense
|
$
3.6
|
$
3.1
|
16.1%
|
|
$
10.7
|
$
10.9
|
(1.8%)
|
|
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)
|
|
2021
|
2020
|
|
2021
|
2020
|
|
Member months
enrollment:
|
|
|
|
|
|
|
Medicare
Advantage
|
|
|
|
410,939
|
407,170
|
|
1,228,732
|
1,220,280
|
|
Medicaid
|
|
1,342,953
|
1,132,626
|
|
3,972,136
|
3,278,098
|
|
Commercial:
|
|
|
|
|
|
|
|
Fully
insured
|
966,002
|
966,906
|
|
2,871,788
|
2,920,460
|
|
|
Self-insured
|
281,153
|
324,372
|
|
875,844
|
981,634
|
|
|
|
Total
Commercial
|
1,247,155
|
1,291,278
|
|
3,747,632
|
3,902,094
|
|
|
|
|
Total member
months
|
3,001,047
|
2,831,074
|
|
8,948,500
|
8,400,472
|
|
Claim liabilities
(in millions)
|
|
|
|
$
533.7
|
$
417.6
|
|
Days claim
payable
|
|
|
|
60
|
57
|
|
Premium
PMPM:
|
|
|
|
|
|
|
Managed
Care
|
$
345.49
|
$
339.09
|
|
$
344.56
|
$
330.12
|
|
|
Medicare
Advantage
|
1,029.59
|
984.11
|
|
1,004.12
|
951.34
|
|
|
Medicaid
|
225.03
|
212.69
|
|
230.78
|
208.32
|
|
|
Commercial
|
221.95
|
215.53
|
|
219.72
|
207.26
|
|
Medical loss
ratio:
|
88.7%
|
84.7%
|
|
88.0%
|
82.7%
|
|
Medicare
Advantage
|
82.5%
|
80.6%
|
|
85.1%
|
80.2%
|
|
Medicaid
|
|
95.2%
|
94.0%
|
|
92.1%
|
92.7%
|
|
Commercial
|
91.9%
|
81.9%
|
|
87.9%
|
76.1%
|
|
Adjusted medical loss
ratio: 1
|
90.7%
|
81.8%
|
|
89.9%
|
81.1%
|
|
Medicare
Advantage
|
84.6%
|
75.0%
|
|
86.8%
|
77.4%
|
|
Medicaid
|
|
99.2%
|
90.9%
|
|
95.6%
|
91.1%
|
|
Commercial
|
90.5%
|
83.8%
|
|
87.8%
|
76.5%
|
|
Operating expense
ratio:
|
|
|
|
|
|
|
Consolidated
|
15.1%
|
17.1%
|
|
15.1%
|
18.7%
|
|
Managed
Care
|
11.6%
|
14.6%
|
|
11.7%
|
15.9%
|
|
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 Business
|
|
|
Managed Care
Membership by Segment
|
As of September
30,
|
|
|
|
|
|
|
2021
|
2020
|
|
Members:
|
|
|
|
|
|
Medicare
Advantage
|
|
|
|
|
136,459
|
136,135
|
|
Medicaid
|
|
449,474
|
385,344
|
|
Commercial:
|
|
|
|
|
Fully
insured
|
321,772
|
321,673
|
|
|
Self-insured
|
94,261
|
107,830
|
|
|
|
Total
Commercial
|
416,033
|
429,503
|
|
|
|
|
Total
members
|
1,001,966
|
950,982
|
|
|
|
|
|
|
|
|
|
Exhibit
V
|
|
|
Reconciliation of
Non-GAAP Financial Measures
|
|
|
Adjusted Net
Income
|
|
(Unaudited)
|
Three months
ended
September 30,
|
|
Nine months
ended
September 30,
|
|
(dollar in
millions)
|
2021
|
2020
|
|
2021
|
2020
|
|
Net income
|
|
$
8.2
|
$
23.6
|
|
$
55.0
|
$
41.0
|
|
Less
adjustments:
|
|
|
|
|
|
|
Net realized
investment gains (losses)
|
1.0
|
0.5
|
|
3.7
|
(0.2)
|
|
Unrealized (losses)
gains on equity investments
|
(7.9)
|
11.0
|
|
13.4
|
(17.4)
|
|
Contingency
accrual
|
-
|
-
|
|
-
|
(32.0)
|
|
Private equity
investment income
|
8.4
|
0.2
|
|
10.8
|
3.9
|
|
GuideWell transaction
costs
|
(1.8)
|
-
|
|
(1.8)
|
-
|
|
Tax impact of
non-GAAP adjustments
|
(1.095)
|
(2.3)
|
|
(6.80)
|
14.0
|
|
|
Adjusted net
income
|
$
9.6
|
$
14.2
|
|
$
35.7
|
$
72.7
|
|
|
Diluted adjusted net
income per share
|
$
0.41
|
$
0.61
|
|
$
1.52
|
$
3.12
|
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. The Company
estimates tax impact of net realized and non-realized gains
(losses), private equity investment income and contingency accrual
at the applicable statutory tax rates. These non-GAAP metrics
do 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:
|
|
Victor J.
Haddock-Morales
|
Mr. Garrett
Edson
|
|
EVP and Chief
Financial Officer
|
ICR
|
|
(787)
749-4949
|
(787)
792-6488
|
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SOURCE Triple-S Management Corporation