Exhibit 99.1
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Triple-S Management Corporation
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1441 F.D. Roosevelt Ave.
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San Juan, PR 00920
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www.triplesmanagement.com
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FOR FURTHER INFORMATION:
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AT THE COMPANY:
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INVESTOR RELATIONS:
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Juan José Román-Jiménez
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Mr. Garrett Edson
|
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EVP and Chief Financial Officer
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ICR
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(787) 749-4949
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(787) 792-6488
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Triple-S Management Corporation Reports Second Quarter 2019 Results
SAN JUAN, Puerto Rico, August 8, 2019 – Triple-S Management Corporation (NYSE:GTS), a leading managed care company in Puerto Rico, today announced its second quarter 2019 results.
Quarterly Consolidated and Other Highlights
| • |
Net income of $30.9 million, or $1.35 per diluted share, versus net loss of $38.7 million, or $1.68 per share, in the prior-year period;
|
| • |
Adjusted net income of $25.7 million, or $1.12 per diluted share, versus adjusted net loss of $37.3 million, or $1.62 per share;
|
| • |
Operating revenues of $878.6 million, a 15.1% increase from the prior-year period, primarily reflecting higher Managed Care net premiums earned;
|
| • |
Consolidated loss ratio improved 1,110 basis points to 82.2%, mostly driven by the unfavorable reserve development related to Hurricane Maria claims recognized by the Property and Casualty segment in the second quarter of 2018;
|
| • |
Medical loss ratio (“MLR”) improved 160 basis points to 84.5%;
|
| • |
Consolidated operating income was $38.2 million, compared to consolidated operating loss of $63.6 million in the prior-year period.
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“We recorded a strong second quarter, driven by an excellent performance from our core Managed Care segment, along with solid results from our Life and P&C segments, leading us to raise our outlook for full year 2019,” said Roberto
Garcia-Rodriguez, President and Chief Executive Officer. “Our ongoing initiatives to enhance our product offering and brand are yielding positive results for Triple-S, reflected in strong year-over-year growth in Managed Care premiums and stable
medical cost trends.”
“In pursuit of our overall growth strategy, we remain focused on creating a unique member experience through a combination of innovative clinical programs, the evolution of our provider network, advanced analytics, competitive pricing and superior
service,” added Mr. Garcia-Rodriguez. “In addition, effective yesterday we completed the conversion of our remaining outstanding Class A shares, simplifying our capital structure into a single class of common shares and increasing our public float,
which should also enhance long-term value for our shareholders.”
1
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Triple-S Management Corporation
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| • |
Consolidated net premiums earned were $859.5 million, up 15.9% from the prior-year period, primarily reflecting higher Medicare membership and premium rates within the Managed Care segment. The increase was partially offset by lower
Medicaid membership resulting from the change in the program’s model and a new entrant to the program in November 2018.
|
| • |
Consolidated claims incurred were $706.3 million, up 2.1% year-over-year. Consolidated loss ratio of 82.2% improved 1,110 basis points from the prior-year period, mostly driven by lower Managed Care MLR on a year-over-year basis, as
well as $76.4 million in unfavorable prior period reserve development related to Hurricane Maria recognized by the Property and Casualty segment in the second quarter of 2018.
|
| • |
Consolidated operating expenses of $134.1 million decreased by $0.5 million, or 0.4%, from the prior-year period primarily resulting from $12.2 million in savings due to the suspension in 2019 of the
HIP Fee, offset by higher personnel costs and commission expense. The Company’s operating expense ratio improved 240 basis points year-over-year to 15.6% mostly driven by the increase in premiums during the second quarter of
2019.
|
| • |
Consolidated income tax expense was $12.9 million, compared to an income tax benefit of $27.9 million in the prior-year period. Income tax expense in 2019 primarily reflects the increase in income before taxes in the Managed Care and
Property and Casualty segments. The income tax benefit in the second quarter of 2018 mainly reflects the loss before taxes in that period in the Property and Casualty segment.
|
Selected Managed Care Segment Quarterly Details
| • |
Managed Care premiums earned were $793.8 million, up 17.0% year over year.
|
| o |
Medicare premiums earned of $366.0 million increased 30.8% from the prior-year period, largely due to an increase of approximately 51,000 member months and higher average premium rates, primarily reflecting a more competitive product
offering and an increase in the average membership risk score.
|
| o |
Medicaid premiums earned increased 11.4% from the prior-year period to $227.0 million, primarily reflecting higher average premium rates in 2019 offset in part by a decrease in enrollment of
approximately 110,000 member months and the suspension of the HIP Fee pass-through in 2019. The decrease in membership was caused by the lower initial membership assigned to Triple-S by ASES when implementing the new contract
effective November 1, 2018. The increase in average premium rates is due to the change in the Medicaid model, where Triple-S now insures members across Puerto Rico, which have higher average premium rates per member, compared to the
previous contract where Triple-S covered only two regions with lower premium rates per member.
|
| o |
Commercial premiums earned of $200.8 million increased 3.1% from the prior-year period, mainly reflecting higher enrollment during the quarter of approximately 15,000 member months and higher average
premium rates, offset by the suspension of the HIP Fee pass-through in 2019.
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2
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Triple-S Management Corporation
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| • |
Reported MLR of 84.5% improved 160 basis points from the prior-year period, primarily reflecting favorable prior period reserve developments. Adjusting for prior period reserve developments and moving risk-score revenue to its
corresponding period in both the 2019 and 2018 quarters, Managed Care MLR for the second quarter of 2019 would have been 85.3%, 130 basis points higher than the prior-year period. This largely reflects
the improved benefits offered in the Medicare 2019 product offering, the elimination of the HIP Fee pass-through, and the higher target MLR of the current Medicaid contract.
|
2019 Outlook
The Company is raising its full year 2019 guidance for consolidated operating revenue, Managed Care premiums earned, and adjusted net income per diluted share, reducing its guidance for operating expense ratio and adjusting its effective tax rate
guidance. It is maintaining its full year 2019 guidance for its consolidated claims incurred ratio and Managed Care MLR. More specifically:
| • |
The Company raised consolidated operating revenue expectations for 2019 to be between $3.29 billion and $3.33 billion, which includes Managed Care premiums earned, net between $2.95 billion and $2.99 billion. The Company’s previous
outlook was for consolidated operating revenue between $3.11 billion and $3.15 billion, which included Managed Care premiums earned, net between $2.78 billion and $2.82 billion;
|
| • |
The Company continues to expect the consolidated claims incurred ratio for 2019 to be between 81.3% and 83.3%, and Managed Care MLR to be between 84.0% and 86.0%;
|
| • |
The Company is reducing consolidated operating ratio expectations for 2019 to be between 17.0% and 17.5%. The Company’s previous outlook was for consolidated operating expense ratio to be between 17.6% and 18.6%;
|
| • |
The Company is adjusting expectations for its effective tax rate to be between 29.0% and 33.0% due to an expected increase in Managed Care operating income, which has a higher tax rate relative to the other segments. The Company’s
previous outlook was for effective tax rate to be between 29.0% and 34.0%; and
|
| • |
The Company raised adjusted net income per diluted share expectations for 2019 to be between $2.40 and $2.60, compared to its previous outlook for adjusted net income per diluted share between $1.90 and $2.10. Adjusted net income per
diluted share guidance accounts for the recently issued share dividend and does not account for any potential share repurchase activity during 2019. Estimated weighted average diluted share count for full year 2019 is expected to be
23.44 million shares.
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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 June 30, 2019. To participate, callers within the U.S. and Canada should dial 1-877-451-6152 and
international callers should dial 1-201-389-0879 at least five 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 and for at least the following two weeks. This news release, along with other information relating to the call, will be available on the “Investor Relations” section of the website.
3
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Triple-S Management Corporation
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In addition, a replay will be available through August 22, 2019 by calling 1-844-512-2921 or 1-412-317-6671 and entering passcode 13692328. A replay will also be available at www.triplesmanagement.com for 30 days.
About Triple-S Management Corporation
Triple-S Management Corporation is an independent licensee of the Blue Cross Blue Shield Association. It is one of the leading players in the managed care industry in Puerto Rico. 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, and Costa Rica. With 60 years of experience in the industry, Triple-S Management offers a broad portfolio of managed care and related products in the Commercial, Medicare
Advantage, and Medicaid markets under the Blue Cross Blue Shield marks. It also provides non-Blue Cross Blue Shield branded life and property and casualty insurance in Puerto Rico. 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
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| • |
Ability to secure sufficient premium rate increases
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| • |
Competitor pricing below market trends of increasing costs
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| • |
Re-estimates of policy and contract liabilities
|
| • |
Changes in government laws and regulations of managed care, life insurance or property and casualty insurance
|
| • |
Significant acquisitions or divestitures by major competitors
|
4
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Triple-S Management Corporation
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| • |
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.
5
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Triple-S Management Corporation
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Earnings Release Schedules and Supplemental Information
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Condensed Consolidated Balance Sheets
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Exhibit I
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Condensed Consolidated Statements of Earnings
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Exhibit II
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Condensed Consolidated Statements of Cash Flows
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Exhibit III
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Segment Performance Supplemental Information
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Exhibit IV
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Reconciliation of Non-GAAP Financial Measures
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Exhibit V
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6
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Triple-S Management Corporation
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Exhibit I
Condensed Consolidated Balance Sheets
(dollar amounts in thousands)
Unaudited
|
June 30,
2019
|
December 31,
2018
|
|||||||
|
Assets
|
||||||||
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Investments
|
$
|
1,600,180
|
$
|
1,564,542
|
||||
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Cash and cash equivalents
|
166,272
|
117,544
|
||||||
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Premium and other receivables, net
|
609,523
|
628,444
|
||||||
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Deferred policy acquisition costs and value of business acquired
|
225,989
|
215,159
|
||||||
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Property and equipment, net
|
85,710
|
81,923
|
||||||
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Other assets
|
149,391
|
152,636
|
||||||
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Total assets
|
$
|
2,837,065
|
$
|
2,760,248
|
||||
|
Liabilities and Stockholders' Equity
|
||||||||
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Policy liabilities and accruals
|
$
|
1,545,423
|
$
|
1,600,310
|
||||
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Accounts payable and accrued liabilities
|
342,964
|
309,747
|
||||||
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Long-term borrowings
|
27,289
|
28,883
|
||||||
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Total liabilities
|
1,915,676
|
1,938,940
|
||||||
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Stockholders’ equity:
|
||||||||
|
Common stock
|
23,151
|
22,931
|
||||||
|
Other stockholders’ equity
|
898,922
|
799,053
|
||||||
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Total Triple-S Management Corporation stockholders’ equity
|
922,073
|
821,984
|
||||||
|
Non-controlling interest in consolidated subsidiary
|
(684
|
)
|
(676
|
)
|
||||
|
Total stockholders’ equity
|
921,389
|
821,308
|
||||||
|
Total liabilities and stockholders’ equity
|
$
|
2,837,065
|
$
|
2,760,248
|
||||
7
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Triple-S Management Corporation
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Exhibit II
Condensed Consolidated Statements of Earnings
(dollar amounts in thousands, except per share data)
Unaudited
|
For the Three Months Ended
June 30, |
For the Six Months Ended
June 30, |
|||||||||||||||
|
2019
|
2018
|
2019
|
2018
|
|||||||||||||
|
Revenues:
|
||||||||||||||||
|
Premiums earned, net
|
$
|
859,493
|
$
|
741,770
|
$
|
1,627,495
|
$
|
1,493,804
|
||||||||
|
Administrative service fees
|
2,456
|
4,066
|
5,088
|
7,414
|
||||||||||||
|
Net investment income
|
15,062
|
15,707
|
30,438
|
29,462
|
||||||||||||
|
Other operating revenues
|
1,591
|
1,588
|
3,168
|
2,659
|
||||||||||||
|
Total operating revenues
|
878,602
|
763,131
|
1,666,189
|
1,533,339
|
||||||||||||
|
Net realized investment gains (losses) on sale of securities
|
2,364
|
(921
|
)
|
3,679
|
2,021
|
|||||||||||
|
|
||||||||||||||||
|
Net unrealized investment gains (losses) on equity investments
|
3,323
|
(776
|
)
|
22,992
|
(16,975
|
)
|
||||||||||
|
|
||||||||||||||||
|
Other income, net
|
1,705
|
494
|
2,874
|
1,657
|
||||||||||||
|
Total revenues
|
885,994
|
761,928
|
1,695,734
|
1,520,042
|
||||||||||||
|
Benefits and expenses:
|
||||||||||||||||
|
Claims incurred
|
706,304
|
692,138
|
1,329,494
|
1,311,127
|
||||||||||||
|
Operating expenses
|
134,084
|
134,612
|
266,747
|
267,746
|
||||||||||||
|
Total operating costs
|
840,388
|
826,750
|
1,596,241
|
1,578,873
|
||||||||||||
|
Interest expense
|
1,831
|
1,825
|
3,619
|
3,515
|
||||||||||||
|
Total benefits and expenses
|
842,219
|
828,575
|
1,599,860
|
1,582,388
|
||||||||||||
|
Income (loss) before taxes
|
43,775
|
(66,647
|
)
|
95,874
|
(62,346
|
)
|
||||||||||
|
Income tax expense (benefit)
|
12,849
|
(27,901
|
)
|
30,165
|
(27,514
|
)
|
||||||||||
|
Net income (loss)
|
30,926
|
(38,746
|
)
|
65,709
|
(34,832
|
)
|
||||||||||
|
Net (loss) income attributable to the non-controlling interest
|
(5
|
)
|
1
|
(8
|
)
|
1
|
||||||||||
|
Net income (loss) attributable to Triple-S Management Corporation
|
$
|
30,931
|
$
|
(38,747
|
)
|
$
|
65,717
|
$
|
(34,833
|
)
|
||||||
|
Earnings per share attributable to Triple-S Management Corporation:
|
||||||||||||||||
|
Basic net income (loss) per share
|
$
|
1.35
|
$
|
(1.68
|
)
|
$
|
2.88
|
$
|
(1.50
|
)
|
||||||
|
Diluted net income (loss) per share
|
$
|
1.35
|
$
|
(1.68
|
)
|
$
|
2.87
|
$
|
(1.50
|
)
|
||||||
|
|
||||||||||||||||
|
Weighted average of common shares
|
22,830,399
|
23,016,447
|
22,794,297
|
23,146,318
|
||||||||||||
|
Diluted weighted average of common shares
|
22,895,000
|
23,016,447
|
22,866,691
|
23,146,318
|
||||||||||||
8
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Triple-S Management Corporation
|
Exhibit III
Condensed Consolidated Statements of Cash Flows
(dollar amounts in thousands)
Unaudited
|
For the Six Months Ended
June 30, |
||||||||
|
2019
|
2018
|
|||||||
|
Net cash provided by operating activities
|
$
|
26,305
|
$
|
130,723
|
||||
|
Cash flows from investing activities:
|
||||||||
|
Proceeds from investments sold or matured:
|
||||||||
|
Securities available for sale:
|
||||||||
|
Fixed maturities sold
|
315,495
|
768,789
|
||||||
|
Fixed maturities matured/called
|
14,420
|
10,656
|
||||||
|
Securities held to maturity - fixed maturities matured/called
|
1,178
|
728
|
||||||
|
Equity investments sold
|
70,054
|
123,197
|
||||||
|
Other invested assets sold
|
2,096
|
1,788
|
||||||
|
Acquisition of investments:
|
||||||||
|
Securities available for sale - fixed maturities
|
(291,533
|
)
|
(829,010
|
)
|
||||
|
Securities held to maturity - fixed maturities
|
(539
|
)
|
(893
|
)
|
||||
|
Equity investments
|
(67,560
|
)
|
(99,944
|
)
|
||||
|
Other invested assets
|
(15,424
|
)
|
(18,649
|
)
|
||||
|
Increase in other investments
|
(2,692
|
)
|
1,817
|
|||||
|
Net change in policy loans
|
(771
|
)
|
(372
|
)
|
||||
|
Net capital expenditures
|
(10,659
|
)
|
(9,116
|
)
|
||||
|
Net cash provided by (used in) investing activities
|
14,065
|
(51,009
|
)
|
|||||
|
Cash flows from financing activities:
|
||||||||
|
Change in outstanding checks in excess of bank balances
|
13,189
|
(1,564
|
)
|
|||||
|
Repayments of long-term borrowings
|
(1,613
|
)
|
(1,618
|
)
|
||||
|
Repurchase and retirement of common stock
|
(1
|
)
|
(16,395
|
)
|
||||
|
Proceeds from policyholder deposits
|
8,204
|
11,606
|
||||||
|
Surrender of policyholder deposits
|
(11,421
|
)
|
(14,705
|
)
|
||||
|
Net cash provided by (used in) financing activities
|
8,358
|
(22,676
|
)
|
|||||
|
|
||||||||
|
Net increase in cash and cash equivalents
|
48,728
|
57,038
|
||||||
|
Cash and cash equivalents, beginning of period
|
117,544
|
198,941
|
||||||
|
Cash and cash equivalents, end of period
|
$
|
166,272
|
$
|
255,979
|
||||
9
|
Triple-S Management Corporation
|
Exhibit IV
Segment Performance Supplemental Information
|
(Unaudited)
|
Three months ended June 30,
|
Six months ended June 30,
|
||||||||||||||||||||||
|
(dollar amounts in millions)
|
2019
|
2018
|
Percentage
Change
|
2019
|
2018
|
Percentage
Change
|
||||||||||||||||||
|
Premiums earned, net:
|
||||||||||||||||||||||||
|
Managed Care:
|
||||||||||||||||||||||||
|
Commercial
|
$
|
200.8
|
$
|
194.7
|
3.1
|
%
|
$
|
399.3
|
$
|
393.5
|
1.5
|
%
|
||||||||||||
|
Medicare
|
366.0
|
279.8
|
30.8
|
%
|
698.6
|
567.7
|
23.1
|
%
|
||||||||||||||||
|
Medicaid
|
227.0
|
203.8
|
11.4
|
%
|
401.4
|
404.1
|
(0.7
|
%)
|
||||||||||||||||
|
Total Managed Care
|
793.8
|
678.3
|
17.0
|
%
|
1,499.3
|
1,365.3
|
9.8
|
%
|
||||||||||||||||
|
Life Insurance
|
45.0
|
41.4
|
8.7
|
%
|
89.2
|
82.9
|
7.6
|
%
|
||||||||||||||||
|
Property and Casualty
|
21.8
|
22.8
|
(4.4
|
%)
|
41.1
|
47.0
|
(12.6
|
%)
|
||||||||||||||||
|
Other
|
(1.1
|
)
|
(0.7
|
)
|
(57.1
|
%)
|
(2.1
|
)
|
(1.4
|
)
|
(50.0
|
%)
|
||||||||||||
|
Consolidated premiums earned, net
|
$
|
859.5
|
$
|
741.8
|
15.9
|
%
|
$
|
1,627.5
|
$
|
1,493.8
|
9.0
|
%
|
||||||||||||
|
Operating revenues (loss): 1
|
||||||||||||||||||||||||
|
Managed Care
|
$
|
802.9
|
$
|
689.3
|
16.5
|
%
|
$
|
1,518.0
|
$
|
1,385.5
|
9.6
|
%
|
||||||||||||
|
Life Insurance
|
51.8
|
48.0
|
7.9
|
%
|
102.6
|
95.6
|
7.3
|
%
|
||||||||||||||||
|
Property and Casualty
|
24.1
|
25.6
|
(5.9
|
%)
|
46.0
|
52.2
|
(11.9
|
%)
|
||||||||||||||||
|
Other
|
(0.2
|
)
|
0.2
|
(200.0
|
%)
|
(0.4
|
)
|
-
|
(100.0
|
%)
|
||||||||||||||
|
Consolidated operating revenues
|
$
|
878.6
|
$
|
763.1
|
15.1
|
%
|
$
|
1,666.2
|
$
|
1,533.3
|
8.7
|
%
|
||||||||||||
|
Operating income (loss): 2
|
||||||||||||||||||||||||
|
Managed Care
|
$
|
29.3
|
$
|
1.4
|
1992.9
|
%
|
$
|
51.4
|
$
|
12.0
|
328.3
|
%
|
||||||||||||
|
Life Insurance
|
5.2
|
5.3
|
(1.9
|
%)
|
10.9
|
9.0
|
21.1
|
%
|
||||||||||||||||
|
Property and Casualty
|
4.8
|
(71.0
|
)
|
106.8
|
%
|
8.3
|
(67.9
|
)
|
(112.2
|
%)
|
||||||||||||||
|
Other
|
(1.1
|
)
|
0.7
|
(257.1
|
%)
|
(0.6
|
)
|
1.4
|
(142.9
|
%)
|
||||||||||||||
|
Consolidated operating income (loss)
|
$
|
38.2
|
$
|
(63.6
|
)
|
160.1
|
%
|
$
|
70.0
|
$
|
(45.5
|
)
|
253.8
|
%
|
||||||||||
|
Operating margin: 3
|
||||||||||||||||||||||||
|
Managed Care
|
3.6
|
%
|
0.2
|
%
|
340
|
bp
|
3.4
|
%
|
0.9
|
%
|
250
|
bp
|
||||||||||||
|
Life Insurance
|
10.0
|
%
|
11.0
|
%
|
-100
|
bp
|
10.6
|
%
|
9.4
|
%
|
120
|
bp
|
||||||||||||
|
Property and Casualty
|
19.9
|
%
|
(277.3
|
%)
|
29,720
|
bp
|
18.0
|
%
|
(130.1
|
%)
|
14,810
|
bp
|
||||||||||||
|
Consolidated
|
4.3
|
%
|
(8.3
|
%)
|
1,260
|
bp
|
4.2
|
%
|
(3.0
|
%)
|
720
|
bp
|
||||||||||||
|
Depreciation and amortization expense
|
$
|
3.5
|
$
|
3.6
|
(2.8
|
%)
|
$
|
7.0
|
$
|
7.0
|
0.0
|
%
|
||||||||||||
|
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.
|
10
|
Triple-S Management Corporation
|
|
Managed Care Additional Data
|
Three months ended
June 30,
|
Six months ended
June 30,
|
||||||||||||||
|
(Unaudited)
|
2019
|
2018
|
2019
|
2018
|
||||||||||||
|
Member months enrollment:
|
||||||||||||||||
|
Commercial:
|
||||||||||||||||
|
Fully-insured
|
955,463
|
940,484
|
1,908,515
|
1,901,774
|
||||||||||||
|
Self-insured
|
353,961
|
439,675
|
716,451
|
889,453
|
||||||||||||
|
Total Commercial
|
1,309,424
|
1,380,159
|
2,624,966
|
2,791,227
|
||||||||||||
|
Medicare Advantage
|
385,835
|
334,887
|
769,443
|
673,227
|
||||||||||||
|
Medicaid
|
1,092,132
|
1,201,743
|
2,121,868
|
2,373,088
|
||||||||||||
|
Total member months
|
2,787,391
|
2,916,789
|
5,516,277
|
5,837,542
|
||||||||||||
|
Claim liabilities (in millions)
|
$
|
423.1
|
$
|
437.5
|
||||||||||||
|
Days claim payable
|
57
|
68
|
||||||||||||||
|
Premium PMPM:
|
||||||||||||||||
|
Managed Care
|
$
|
326.21
|
$
|
273.83
|
$
|
312.37
|
$
|
275.92
|
||||||||
|
Commercial
|
210.16
|
207.02
|
209.22
|
206.91
|
||||||||||||
|
Medicare Advantage
|
948.59
|
835.51
|
907.93
|
843.25
|
||||||||||||
|
Medicaid
|
207.85
|
169.59
|
189.17
|
170.28
|
||||||||||||
|
Medical loss ratio:
|
84.5
|
%
|
86.1
|
%
|
84.1
|
%
|
85.5
|
%
|
||||||||
|
Commercial
|
80.9
|
%
|
80.2
|
%
|
81.9
|
%
|
80.8
|
%
|
||||||||
|
Medicare Advantage
|
82.4
|
%
|
88.4
|
%
|
81.5
|
%
|
86.4
|
%
|
||||||||
|
Medicaid
|
91.1
|
%
|
88.5
|
%
|
90.7
|
%
|
88.9
|
%
|
||||||||
|
Adjusted medical loss ratio: 1
|
85.3
|
%
|
84.0
|
%
|
85.6
|
%
|
83.9
|
%
|
||||||||
|
Commercial
|
82.6
|
%
|
84.0
|
%
|
82.3
|
%
|
83.4
|
%
|
||||||||
|
Medicare Advantage
|
83.2
|
%
|
82.5
|
%
|
84.3
|
%
|
82.2
|
%
|
||||||||
|
Medicaid
|
91.1
|
%
|
85.8
|
%
|
91.4
|
%
|
86.7
|
%
|
||||||||
|
Operating expense ratio:
|
||||||||||||||||
|
Consolidated
|
15.6
|
%
|
18.0
|
%
|
16.3
|
%
|
17.8
|
%
|
||||||||
|
Managed Care
|
12.9
|
%
|
15.2
|
%
|
13.7
|
%
|
15.0
|
%
|
||||||||
|
1
|
The adjusted medical loss ratio and adjusted consolidated loss ratio accounts for subsequent adjustments to estimates, such as prior-period reserve developments and Medicare premium adjustments, and presents
then in their corresponding period.
|
|
Managed Care Membership by Segment
|
As of June 30,
|
|||||||
|
2019
|
2018
|
|||||||
|
Members:
|
||||||||
|
Commercial:
|
||||||||
|
Fully-insured
|
318,429
|
312,049
|
||||||
|
Self-insured
|
117,978
|
145,040
|
||||||
|
Total Commercial
|
436,407
|
457,089
|
||||||
|
Medicare Advantage
|
128,670
|
111,667
|
||||||
|
Medicaid
|
364,495
|
404,338
|
||||||
|
Total members
|
929,572
|
973,094
|
||||||
11
|
Triple-S Management Corporation
|
Exhibit V
Reconciliation of Non-GAAP Financial Measures
|
Adjusted Net Income (Loss)
|
||||||||||||||||
|
(Unaudited)
|
Three months ended
June 30,
|
Six months ended
June 30,
|
||||||||||||||
|
(dollar amounts in millions)
|
2019
|
2018
|
2019
|
2018
|
||||||||||||
|
Net income (loss)
|
$
|
30.9
|
$
|
(38.7
|
)
|
$
|
65.7
|
$
|
(34.8
|
)
|
||||||
|
Less adjustments:
|
||||||||||||||||
|
Net realized investment gains (losses), net of tax
|
1.9
|
(0.7
|
)
|
2.9
|
1.6
|
|||||||||||
|
Unrealized gains (losses) on equity investments
|
2.7
|
(0.6
|
)
|
18.4
|
(13.6
|
)
|
||||||||||
|
Private equity investment income (loss), net of tax
|
0.7
|
(0.1
|
)
|
1.0
|
0.4
|
|||||||||||
|
Adjusted net income (loss)
|
$
|
25.6
|
$
|
(37.3
|
)
|
$
|
43.4
|
$
|
(23.2
|
)
|
||||||
|
Diluted adjusted net income (loss) per share
|
$
|
1.12
|
$
|
(1.62
|
)
|
$
|
1.90
|
$
|
(1.00
|
)
|
||||||
|
Adjusted Net Income (Loss) and Operating Income
(Loss) Excluding Property and Casualty
Unfavorable Development
|
||||||||||||||||
|
(Unaudited)
|
Three months ended
June 30,
|
Six months ended
June 30,
|
||||||||||||||
|
(dollar amounts in millions)
|
2019
|
2018
|
2019
|
2018
|
||||||||||||
|
Adjusted net income (loss)
|
$
|
25.6
|
$
|
(37.3
|
)
|
$
|
43.4
|
$
|
(23.2
|
)
|
||||||
|
Less unfavorable prior period reserve development, net of tax
|
-
|
47.5
|
-
|
47.5
|
||||||||||||
|
Adjusted net income excluding Property and Casualty unfavorable prior period reserve development
|
$
|
25.6
|
$
|
10.2
|
$
|
43.4
|
$
|
24.3
|
||||||||
|
Diluted adjusted net income per share excluding
|
||||||||||||||||
|
Property and Casualty unfavorable prior period reserve development
|
$
|
1.12
|
$
|
0.44
|
$
|
1.90
|
$
|
1.05
|
||||||||
|
Operating income (loss)
|
$
|
38.2
|
$
|
(63.6
|
)
|
$
|
70.0
|
$
|
(45.5
|
)
|
||||||
|
Less unfavorable prior period reserve development
|
-
|
76.4
|
-
|
76.4
|
||||||||||||
|
Operating income (loss) excluding Property and Casualty unfavorable prior period reserve development
|
$
|
38.2
|
$
|
12.8
|
$
|
70.0
|
$
|
30.9
|
||||||||
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 do not consider all of 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.
12