Press Release

Triple-S Management Corporation Reports Third Quarter 2019 Results

Company Release - 11/7/2019 6:00 AM ET

SAN JUAN, Puerto Rico, Nov. 7, 2019 /PRNewswire/ -- Triple-S Management Corporation (NYSE: GTS), a leading managed care company in Puerto Rico, today announced its third quarter 2019 results.

(PRNewsfoto/Triple-S Management Corporation)

Quarterly Consolidated and Other Highlights

  • Net income of $13.9 million, or $0.58 per diluted share, versus net loss of $17.6 million, or $0.77 per share, in the prior-year period;
  • Adjusted net income of $12.1 million, or $0.51 per diluted share, versus adjusted net loss of $22.2 million, or $0.97 per share, in the prior-year period;
  • Operating revenues of $836.0 million, a 9.4% increase from the prior-year period, primarily reflecting higher Managed Care net premiums earned;
  • Consolidated loss ratio decreased 400 basis points to 83.4% versus the third quarter of 2018; this results from the unfavorable reserve development related to Hurricane Maria claims recognized by the Property and Casualty ("P&C") segment in the prior-year period;
  • Medical loss ratio ("MLR") increased 320 basis points to 86.4%;
  • Consolidated operating income was $19.0 million, compared to consolidated operating loss of $25.6 million in the prior-year period;
  • Expansion of share repurchase program to $25 million of availability, approved subsequent to quarter end.

"We had a solid third quarter, mainly driven by year-over-year growth in Medicare premiums and valuable bottom line contributions from our Life and P&C segments," said Roberto Garcia-Rodriguez, President and Chief Executive Officer.  "We've continued strengthening our product offerings, improving the overall quality of service, and advancing our goal of creating a unique and optimal member experience."

"With respect to our P&C segment, our quarterly review of outstanding claims reaffirms our belief that our reserves remain adequate as of September 30, 2019," added Mr. Garcia-Rodriguez.  "Given our confidence in the Company's long-term strategy and our belief that its stock is undervalued, our Board has expanded our share repurchase program's availability to $25 million.  We anticipate commencing repurchases under the program during the week of November 11, 2019."

Selected Consolidated Quarterly Details

  • Consolidated net premiums earned were $815.0 million, up 9.8% from the prior-year period, primarily reflecting higher average premium rates within the Managed Care segment and an increase in membership in the Medicare and fully insured Commercial businesses. The increase was partially offset by lower Medicaid membership.
  • Consolidated claims incurred were $680.0 million, up 4.8% year-over-year. Consolidated loss ratio of 83.4% improved 400 basis points from the prior-year period, driven by the $52.3 million unfavorable prior period reserve development related to Hurricane Maria recognized by the P&C segment in the third quarter of 2018 that did not recur in the third quarter of 2019.
  • Consolidated operating expenses of $136.9 million decreased by $4.1 million, or 2.9%, from the prior-year period, primarily resulting from savings due to the suspension in 2019 of the HIP Fee, partially offset by higher personnel costs and commission expense. The Company's operating expense ratio improved 220 basis points year-over-year to 16.7%, mostly driven by the increase in premiums during the third quarter of 2019.
  • Consolidated income tax expense was $5.9 million, compared to an income tax benefit of $3.4 million in the prior-year period. The income tax benefit in the third quarter of 2018 mainly reflects the loss before taxes in that period incurred by the P&C segment.

Selected Managed Care Segment Quarterly Details

  • Managed Care premiums earned were $746.5 million, up 9.7% year over year.
    • Medicare premiums earned of $367.1 million increased 29.4% from the prior-year period, largely due to an increase of approximately 52,000 member months and higher average premium rates, primarily reflecting a more competitive product offering and an increase in the average membership risk score.
    • Commercial premiums earned of $203.1 million increased 2.9% from the prior-year period, mainly reflecting higher fully insured enrollment during the quarter of approximately 25,000 member months and higher average premium rates, partially offset by the suspension of the HIP Fee pass-through in 2019.
    • Medicaid premiums earned decreased 11.8% from the prior-year period to $176.3 million, primarily reflecting a decrease in membership of approximately 126,000 member months, and the suspension of the HIP Fee pass-through in 2019. The decrease in membership follows the lower membership assigned to Triple-S by ASES when implementing the new Medicaid contract that became effective November 1, 2018.
  • Reported MLR of 86.4% increased 320 basis points from the prior-year period. This increase largely reflected the improved benefits offered in the Medicare Advantage 2019 product offering, the elimination of the HIP Fee pass-through, and the higher target MLR of the current Medicaid contract.

Update on P&C Segment Reserves related to Hurricane María

As of September 30, 2019:

  • Triple-S Propiedad, Inc. (TSP), the Company's P&C subsidiary, has paid a cumulative amount of $692 million in claims related to Hurricane María. Estimated gross losses remain unchanged at $967 million.
  • TSP received 10 new claims during the third quarter, increasing the total number of claims to 17,746. It has closed approximately 96% of these claims. 709 claims remain open.
  • The Company evaluated any developments involving open claims, including new information that arose from lawsuits in which TSP has been served, as is customary when the Company conducts its quarterly review of TSP's reserve levels. In addition, as described below, the Company conducted additional analysis of case reserves for claims in which lawsuits have been filed against TSP but not served.
  • TSP has been served with process in 218 lawsuits related to the 709 claims that remain open.
  • The Company conducted a search of the Puerto Rico court system's electronic docket to identify lawsuits filed against TSP with respect to which TSP has not been served. This docket is a public record over which the Company has no control; furthermore, the Company is unable to verify its accuracy or completeness.
  • The docket search identified an additional 178 lawsuits filed against TSP that have not yet been served as required by law. All of them relate to claims previously registered with and evaluated by the Company.
  • The Company then performed additional analysis of case reserves for claims in which lawsuits have been filed against TSP but not served. Based on this analysis, as well as the customary review described above, the Company determined that there is no need to increase its estimate of gross losses nor adjust reserves related to Hurricane María.
  • As is the case for all claim liabilities, the gross losses related to Hurricane Maria are based on the Company's best estimate of the ultimate expected cost of claims with the information currently on hand and are subject to change.

Results of Internal Investigation Related to Vital RFP

As previously disclosed in an 8-K filed with the Securities and Exchange Commission on July 30, 2019, the Company's audit committee of independent directors engaged outside counsel to conduct a proactive investigation into the Company's participation in the Vital RFP process.  That investigation is substantially complete and has not uncovered any evidence of attempts by the Company to improperly influence the outcome of the Vital RFP process.

2019 Outlook

The Company is raising its full year 2019 guidance for adjusted net income per diluted share and reducing its guidance for operating expense ratio.  It is maintaining its full year 2019 guidance for its consolidated operating income revenue, Managed Care premiums, consolidated claims incurred ratio and Managed Care MLR ratio.  More specifically:

  • The Company continues to expect consolidated operating revenue 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 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 16.75% and 17.25%. The Company's previous outlook was for consolidated operating expense ratio to be between 17.0% and 17.5%;
  • The Company continues to expect its effective tax rate to be between 29.0% and 33.0%; and
  • The Company raised adjusted net income per diluted share expectations for 2019 to be between $2.50 and $2.70, compared to its previous outlook for adjusted net income per diluted share between $2.40 and $2.60. Adjusted net income per diluted share guidance accounts for the August 2019 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 23.443 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, 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.

In addition, a replay will be available through November 21, 2019 by calling 1-844-512-2921 or 1-412-317-6671 and entering passcode 13695866. 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
  • Ability to secure sufficient premium rate increases
  • Competitor pricing below market trends of increasing costs
  • 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
  • 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,
2019


December 31,
2018

Assets



















Investments


$

1,645,703


$

1,564,542

Cash and cash equivalents



98,932



117,544

Premium and other receivables, net



608,305



628,444

Deferred policy acquisition costs and value of business acquired


232,948



215,159

Property and equipment, net



86,299



81,923

Other assets



158,179



152,636












Total assets


$

2,830,366


$

2,760,248























Liabilities and Stockholders' Equity



















Policy liabilities and accruals


$

1,493,612


$

1,600,310

Accounts payable and accrued liabilities



361,571



309,747

Long-term borrowings



26,492



28,883












Total liabilities



1,881,675



1,938,940











Stockholders' equity:








Common stock



24,333



22,931


Other stockholders' equity



925,044



799,053












Total Triple-S Management Corporation stockholders' equity


949,377



821,984













Non-controlling interest in consolidated subsidiary



(686)



(676)













Total stockholders' equity



948,691



821,308













Total liabilities and stockholders' equity


$

2,830,366


$

2,760,248

 

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,









2019


2018


2019


2018

Revenues:

















Premiums earned, net


$

815,021


$

742,445


$

2,442,516


$

2,236,249


Administrative service fees



2,607



3,802



7,695



11,216


Net investment income



15,176



16,168



45,614



45,630


Other operating revenues



3,167



1,575



6,335



4,234



Total operating revenues



835,971



763,990



2,502,160



2,297,329





















Net realized investment gains (losses) on sale of securities



1,087



(956)



4,766



1,065


Net unrealized investment gains (losses) on equity investments



1,267



5,632



24,259



(11,343)


Other income, net



485



1,943



3,359



3,600



Total revenues



838,810



770,609



2,534,544



2,290,651
















Benefits and expenses:














Claims incurred




680,010



648,580



2,009,504



1,959,707


Operating expenses



136,882



141,026



403,629



408,772



Total operating costs



816,892



789,606



2,413,133



2,368,479





















Interest expense



2,062



2,000



5,681



5,515


















Total benefits and expenses



818,954



791,606



2,418,814



2,373,994


















Income (loss) before taxes



19,856



(20,997)



115,730



(83,343)
















Income tax expense (benefit)



5,910



(3,430)



36,075



(30,944)
















Net income (loss)




13,946



(17,567)



79,655



(52,399)

















Net (loss) income attributable to the non-controlling interest



(2)



-



(10)



1
















Net income (loss) attributable to Triple-S Management Corporation

$

13,948


$

(17,567)


$

79,665


$

(52,400)




















Earnings per share attributable to Triple-S Management Corporation:
































Basic net income (loss) per share


$

0.59


$

(0.77)


$

3.44


$

(2.27)


Diluted net income (loss) per share


$

0.58


$

(0.77)


$

3.43


$

(2.27)





















Weighted average of common shares



23,830,106



22,895,582



23,143,361



23,058,754


Diluted weighted average of common shares



23,893,807



22,895,582



23,217,298



23,058,754

 

Exhibit III

Condensed Consolidated Statements of Cash Flows

(dollar amounts in thousands)

Unaudited




















 

For the Nine Months Ended








September 30,








2019


2018













Net cash used in operating activities


$

(3,455)


$

(3,928)











Cash flows from investing activities:








Proceeds from investments sold or matured:









Securities available for sale:









     Fixed maturities sold



365,383



1,042,720



     Fixed maturities matured/called



19,017



18,133



Securities held to maturity - fixed maturities matured/called



1,378



2,066



Equity investments sold



126,134



150,024



Other invested assets sold



3,379



2,040


Acquisition of investments:









Securities available for sale - fixed maturities



(397,956)



(1,113,587)



Securities held to maturity - fixed maturities



(748)



(2,238)



Equity investments



(88,945)



(113,108)



Other invested assets 



(24,233)



(38,501)


Increase in other investments



(2,710)



(144)


Net change in policy loans



(1,097)



(603)


Net capital expenditures



(14,746)



(12,315)













Net cash used in investing activities



(15,144)



(65,513)











Cash flows from financing activities:








Change in outstanding checks in excess of bank balances



3,808



9,104


Repayments of long-term borrowings



(2,425)



(2,427)


Repurchase and retirement of common stock



(1)



(22,390)


Proceeds from policyholder deposits



15,060



14,726


Surrender of policyholder deposits



(16,455)



(21,422)













Net cash used in financing activities



(13)



(22,409)













Net decrease in cash and cash equivalents



(18,612)



(91,850)













Cash and cash equivalents, beginning of period



117,544



198,941











Cash and cash equivalents, end of period


$

98,932


$

107,091

 

Exhibit IV

Segment Performance Supplemental Information

(Unaudited)


Three months ended September 30,


Nine months ended September 30,

(dollar amounts in millions)

2019

2018

Percentage
Change


2019

2018

Percentage
Change

Premiums earned, net:









Managed Care:










Commercial

$     203.1

$     197.3

2.9%


$     602.4

$     590.8

2.0%



Medicare

367.1

283.6

29.4%


1,065.7

851.3

25.2%



Medicaid

176.3

199.8

(11.8%)


577.7

603.9

(4.3%)




Total Managed Care

746.5

680.7

9.7%


2,245.8

2,046.0

9.8%


Life Insurance

45.8

42.3

8.3%


135.1

125.1

8.0%


Property and Casualty

23.7

20.2

17.3%


64.9

67.1

(3.3%)


Other



(1.0)

(0.8)

25.0%


(3.3)

(1.9)

73.7%





Consolidated premiums earned, net

$     815.0

$     742.4

9.8%


$   2,442.5

$   2,236.3

9.2%

Operating revenues (loss): 1









Managed Care

$     755.8

$     692.4

9.2%


$   2,273.7

$   2,077.8

9.4%


Life Insurance

52.5

48.7

7.8%


155.1

144.2

7.6%


Property and Casualty

26.2

22.7

15.4%


72.3

74.8

(3.3%)


Other



1.4

0.2

600.0%


1.0

0.5

100.0%





Consolidated operating revenues

$     835.9

$     764.0

9.4%


$   2,502.1

$   2,297.3

8.9%

Operating income (loss): 2









Managed Care

$         5.4

$       14.2

(62.0%)


$       56.8

$       26.3

116.0%


Life Insurance

6.6

5.7

15.8%


17.5

14.6

19.9%


Property and Casualty

6.6

(46.9)

114.1%


14.9

(114.8)

113.0%


Other



0.4

1.4

(71.4%)


(0.2)

2.7

(107.4%)





Consolidated operating income (loss)

$       19.0

$      (25.6)

174.2%


$       89.0

$      (71.2)

225.0%

Operating margin: 3









Managed Care

0.7%

2.1%

-140 bp


2.5%

1.3%

120 bp


Life Insurance

12.6%

11.7%

90 bp


11.3%

10.1%

120 bp


Property and Casualty

25.2%

(206.6%)

23,180 bp


20.6%

(153.5%)

17,410 bp


Consolidated

2.3%

(3.4%)

570 bp


3.6%

(3.1%)

670 bp

Depreciation and amortization expense

$         3.7

$         3.0

23.3%


$       10.7

$         9.9

8.1%


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)


2019

2018

2019

2018

Member months enrollment:



Commercial:




Fully-insured


964,321



939,110



2,872,836



2,840,884




Self-insured


356,059



427,791



1,072,510



1,317,244





Total Commercial


1,320,380



1,366,901



3,945,346



4,158,128



Medicare Advantage





386,995



334,836



1,156,438



1,008,063



Medicaid



1,065,885



1,191,681



3,187,753



3,564,769






Total member months


2,773,260



2,893,418



8,289,537



8,730,960


Claim liabilities (in millions)



$

390.3


$

413.3


Days claim payable




56



65


Premium PMPM:



Managed Care

$

308.83


$

276.08


$

311.18


$

275.97




Commercial

210.61


210.09



209.69



207.96




Medicare Advantage

948.59


846.98



921.54



844.49




Medicaid 

165.40


167.66



181.22



169.41


Medical loss ratio:


86.4

%


83.2

%


84.9

%


84.7

%


Commercial


84.7

%


84.5

%


82.8

%


82.0

%


Medicare Advantage


81.1

%


80.3

%


81.4

%


84.4

%


Medicaid 



99.6

%


85.9

%


93.4

%


87.9

%

Adjusted medical loss ratio: 1



86.5

%


82.8

%


85.8

%


83.9

%


Commercial



84.5

%


82.7

%


83.5

%


83.2

%


Medicare Advantage



81.7

%


79.6

%


81.8

%


82.3

%


Medicaid 



98.1

%


87.3

%


95.7

%


86.9

%

Operating expense ratio:



Consolidated


16.7

%


18.9

%


16.5

%


18.2

%


Managed Care


14.0

%


16.3

%


13.8

%


15.4

%


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

As of September 30,







2019

2018

Members:






Commercial:




     Fully-insured

322,992

313,729


     Self-insured

119,077

140,094


          Total Commercial

442,069

453,823


Medicare Advantage





128,660

111,389


Medicaid


354,230

394,149


          Total members

924,959

959,361

 

Exhibit V

Reconciliation of Non-GAAP Financial Measures







Adjusted Net Income (Loss)

(Unaudited)

Three months ended
September 30,

Nine months ended 
September 30,

(dollar amounts in millions)

2019

2018


2019

2018

Net income (loss)

$

13.9

$

(17.6)


$

79.7

$

(52.4)

Less adjustments:







Net realized investment gains (losses), net of tax

0.9

(0.8)


3.8

0.8


Unrealized gains (losses) on equity investments

1.0

4.5


19.4

(9.1)


Private equity investment income (loss), net of tax

(0.1)

0.9


1.0

1.3



Adjusted net income (loss)

$

12.1

$

(22.2)


$

55.6

$

(45.4)



Diluted adjusted net income (loss) per share

$

0.51

$

(0.97)


$

2.39

$

(1.96)


























Adjusted Net Income (Loss) and Operating Income
(Loss) Excluding Property and Casualty
Unfavorable Development











(Unaudited)

Three months ended
September 30,

Nine months ended
September 30,

(dollar amounts in millions)

2019

2018


2019

2018

Adjusted net income (loss)

$

12.1

$

(22.2)


$

55.6

$

(45.4)

Less unfavorable prior period reserve development, net of tax

-

35.9


-

85.4



Adjusted net income excluding P&C unfavorable









prior period reserve development

$

12.1

$

13.7


$

55.6

$

40.0



Diluted adjusted net income per share excluding









P&C unfavorable prior period reserve development

$

0.51

$

0.60


$

2.39

$

1.73

Operating income (loss)

$

19.0

$

(25.6)


$

89.0

$

(71.2)

Less unfavorable prior period reserve development

-

52.3


-

128.7



Operating income excluding P&C unfavorable









prior period reserve development

$

19.0

$

26.7


$

89.0

$

57.5

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 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.

 

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

 

 

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SOURCE Triple-S Management Corporation