Triple-S Management Corporation (TSM) is the leading managed care company in Puerto Rico. With over one million customers. In addition to its core managed care business, TSM operates two complementary businesses in life, and property and casualty insurance. Since 1965, Triple-S, Inc. has been an independent licensee of the Blue Cross and Blue Shield Association, holding the exclusive rights to the Blue Cross and Blue Shield name and trademark in Puerto Rico and the US Virgin Islands. This provides its members with valuable access to the Blue Card network in the U.S. It is the only managed care company that serves all market sectors, including Medicare, Medicaid, Group and Individual, in Puerto Rico and is one of the most recognized brands locally.