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Triple-S Management Corporation Reports Third Quarter 2009 Results

SAN JUAN, Puerto Rico, Nov. 3 /PRNewswire-FirstCall/ -- Triple-S Management Corporation (NYSE: GTS), the largest managed care company in Puerto Rico, today announced consolidated revenues of $507.3 million and operating income of $15.4 million for the three months ended September 30, 2009. Net income of $18.1 million, or $0.62 per diluted share, includes an after tax net gain of $6.3 million, or $0.22 per share, in net realized and unrealized gains on investments and derivatives.

Third-Quarter Highlights

  • Total consolidated operating revenues increased 10.7 percent year over year to $500.2 million
  • Operating income was $15.4 million
  • Excluding net realized and unrealized gains on investments and a derivatives gain included within other income (expenses), net income was $11.8 million, or $0.40 per diluted share
  • Consolidated loss ratio was 86.6 percent and the medical loss ratio (MLR) was 90.3 percent
  • Consolidated operating expense ratio rose 10 basis points to 14.6 percent
  • Commercial member months enrollment, including ASO, increased 28.0 percent
  • Net cash flow provided by operating activities of $17.5 million

"During the period, we posted double-digit growth in our Commercial membership, registered incremental improvement in the adjusted MLR for our Medicare Advantage segment, and continued to generate positive operating cash flow," said Ramon M. Ruiz-Comas, President and Chief Executive Officer. "As we enter the seasonally strong fourth quarter, the combination of more favorable utilization trends and higher premiums should allow us to reduce our MLR in both the Commercial and Medicare Advantage businesses. However, we were not immune to the impact of swine flu which was particularly noticeable among our younger Commercial members."

Ruiz-Comas added, "Through the first nine months of 2009, we have successfully pursued a simple and straightforward strategy that we initially implemented several years ago. By leveraging our market leadership position, highly efficient cost structure, and healthy capital base, we have created a strong foundation that should sustain solid, profitable growth into 2010 and beyond."

Consolidated operating revenues for the three months ended September 30, 2009, were $500.2 million, 10.7 percent above the prior-year period. The increase resulted primarily from growth in Commercial membership, reflecting, in large part, the acquisition of La Cruz Azul (LCA) and the addition of the Metro-North region in the Reform business, as well as higher premium rates across all businesses.

Consolidated claims incurred and operating expenses for the period were $484.8 million, an increase of 13.0 percent from the same period last year. Consolidated claims incurred were $413.6 million, up 13.1 percent from a year ago, principally due to increased claims in the managed care segment resulting from higher enrollment and the addition of LCA's members. The consolidated loss ratio rose 220 basis points from the prior-year period, to 86.6 percent, largely reflecting the increased utilization among local government employees, the effect of reserve developments in our managed care segment, and the impact of premium adjustments in the Reform business. Excluding the effect of those items, the consolidated loss ratio increased 150 basis points. Operating expenses came in at $71.2 million, an 11.9 percent year-over-year increase, primarily resulting from higher volume in the Commercial business, incremental expenses associated with the acquisition of LCA's membership, and the addition of the Metro-North region ASO contract in November 2008. The consolidated operating expense ratio rose 10 basis points, to 14.6 percent.

Net income for the three months ended September 30, 2009, was $18.1 million, or $0.62 per diluted share, based on weighted average shares outstanding of 29.4 million. This compares with net income for the three months ended September 30, 2008, of $9.5 million, or $0.29 per diluted share, based on weighted average shares outstanding of 32.2 million. The earnings for the three months ended September 30, 2009, include $0.21 per diluted share in after tax net realized and unrealized gains on investments and an increase in the unrealized gain in derivatives of $0.01 per diluted share included within other income (expenses). Excluding the effect of these items for the three months ended September 30, 2009, net income was $11.8 million, or $0.40 per diluted share, compared with $14.9 million, or $0.46 per diluted share, in the comparable 2008 quarter.

    (Unaudited)                                 Pro Forma Net Income
                                                Three            Nine
                                            months ended     months ended
    (dollar amounts in millions)            September 30,    September 30,
                                           2009       2008   2009     2008
                                           ----       ----   ----     ----
     Pro forma net income:
      Net income                          $18.1      $9.5   $40.7    $22.8
      Net realized investment (gains)
       losses, net of tax                  (1.9)      0.9     1.0      1.8
      Net unrealized trading investments
       (gains) losses, net of tax          (4.1)      3.1    (6.8)    10.1
      Derivative (gain) loss, net of tax   (0.3)      1.4     0.1      3.8
                                           ----       ---     ---      ---
               Pro forma net income       $11.8     $14.9   $35.0    $38.5
               --------------------       -----     -----   -----    -----

     Diluted pro forma net income
      per share                           $0.40     $0.46   $1.17    $1.20
     ------------------------------       -----     -----   -----    -----

Nine-Month Recap

For the nine months ended September 30, 2009, consolidated operating revenues rose 11.8 percent to $1.47 billion, primarily reflecting the growth in the managed care segment. Consolidated claims incurred for the nine months ended September 30, 2009 were $1.21 billion, up 12.7 percent year over year. The consolidated loss ratio increased 120 basis points to 86.4 percent. Nine-month consolidated operating expenses were $208.1 million and the operating expense ratio remained at 14.6 percent. Pro forma net income for the nine months ended September 30, 2009 was $35.0 million, or $1.17 per diluted share, based on weighted average shares outstanding of 29.7 million, compared with $38.5 million, or $1.20 per diluted share, based on weighted average shares outstanding of 32.2 million at the same time last year.

For the aforementioned nine-month period, net cash provided by operating activities amounted to $66.7 million. As of September 30, 2009, Triple-S Management had $36.3 million in parent company cash, cash equivalents, and investments.

Segment Performance

Triple-S Management operates in three segments: 1) Managed Care, 2) Life Insurance, and 3) Property and Casualty Insurance. Management evaluates performance based primarily on the operating revenues and operating income of each segment. Operating revenues include premiums earned, net administrative service fees and net investment income. Operating costs include claims incurred and operating expenses. The Company calculates operating income or loss as operating revenues minus operating expenses. Operating margin is defined as operating gain or loss divided by operating revenues.

                      Three months ended               Nine months ended
    (dollar amounts      September 30,                   September 30,
     in millions)                     Percentage                    Percentage
                    2009      2008      Change     2009        2008   Change
                    ----      ----      ------     ----        ----   ------
       Care        $445.3    $399.0      11.6%  $1,299.9    $1,154.1   12.6%
       Insurance     28.8      27.7       4.0%      87.0        80.7    7.8%
       and Casualty  27.4      25.8       6.2%      81.8        78.2    4.6%
      Other          (1.3)     (0.7)     85.7%      (3.6)       (2.3)  56.5%
                     ----      ----      ----       ----        ----   ----
         revenues  $500.2    $451.8      10.7%  $1,465.1    $1,310.7   11.8%
                    -----     -----      ----    -------     -------   ----

       Care         $10.1     $15.1     (33.1%)    $32.1       $34.4   (6.7%)
       Insurance      4.0       3.0      33.3%      10.9         8.7   25.3%
       and Casualty   0.2       2.9     (93.1%)      4.4         7.3  (39.7%)
      Other           1.1       1.6     (31.3%)      3.0         4.7  (36.2%)
                      ---       ---      ----        ---         ---   ----
         income     $15.4     $22.6     (31.9%)    $50.4       $55.1   (8.5%)
                     ----      ----      ----       ----        ----    ---

       Care          2.3%      3.8%    -150 bp      2.5%        3.0%  -50 bp
       Insurance    13.9%     10.8%     310 bp     12.5%       10.8%  170 bp
       and Casualty  0.7%     11.2%   -1050 bp      5.4%        9.3% -390 bp
      Consolidated   3.1%      5.0%    -190 bp      3.4%        4.2%  -80 bp

Managed Care Results Summary

Total medical premiums earned for the three months ended September 30, 2009 were $429.4 million, up 10.7 percent from the same period in 2008, primarily due to higher Commercial member enrollment, reflecting, in large part, the acquisition of La Cruz Azul (LCA), as well as higher premium rate increases across all businesses.

Medical premiums generated by the Commercial business were up $32.9 million, or 17.8 percent, to $217.3 million, the net result of an increase of 207,017, or 16.8 percent, in member months enrollment and a 1.5% rise in the average premium rate. More than half of the increase in member months enrollment (115,648) was attributable to the LCA acquisition, which became effective on July 1, 2009, with the remainder coming from other new groups added during the period.

Medical premiums earned in the Medicare business rose $9.6 million, or 8.5 percent, to $122.7 million, largely the result of higher average premium rates, particularly for the dual-eligible product. Offsetting the premium rate increases was a decline in member months enrollment of 12,204, or 5.5%, reflecting decreases of 9,640, or 5.1%, in Medicare Advantage membership and 2,564, or 8.0%, in PDP membership.

Medical premiums generated by the Reform business fell $1.0 million, or 1.1 percent, to $89.4 million. The decline reflects a reduction of 12,799, or 1.2 percent, in fully-insured membership and a $2.9 million premium adjustment to provide for unresolved reconciling items.

Administrative service fees, which amounted to $10.5 million, were up $5.3 million, or 101.9 percent, due to an increase in member months enrollment of 875,752. This sharp rise mainly reflects the Metro-North region ASO contract, which became effective in November 2008, as well as new ASO commercial contracts that went into effect January 1, 2009. In addition, the contracts acquired from LCA included several ASO groups. For the three months ended September 30, 2009, total member months enrollment for the Metro-North region and LCA totaled 590,117 and 255,494, respectively.

Medical claims incurred increased by $43.9 million, or 12.8 percent, to $387.7 million, largely driven by the higher volume of business and MLR. The overall MLR increased 170 basis points during the three months ended September 30, 2009, to 90.3 percent. This increase was the result of the changes in the reserve estimates that affected the claims reserve in both periods, offset, in part, by the effect of the aforementioned premium adjustments in the Reform business. Excluding the effect of prior period reserve developments in 2009 and 2008, and considering the effect of premium adjustments, the MLR was 89.4 percent in 2009 and 89.2 percent in 2008. The increase in MLR largely reflects the increased utilization related to the AH1N1, or swine flu, and among local government employees. During the three months ended September 30, 2009 the segment experienced a $2.1 million, or 50 basis points, increase in utilization related to the AH1N1, or swine, flu.

Operating expenses were up $7.4 million year over year, or 18.5 percent, to $47.5 million, primarily attributable to the higher volume of business associated with increased enrollment, the addition of the Metro-North region ASO contract in November 2008, as well as incremental expenses related to the acquisition of LCA's membership. The segment's operating expense ratio rose 60 basis points, to 10.8 percent.

                              Three months ended         Nine months ended
    Managed Care Additional      September 30,             September 30,
     Data                    2009            2008        2009         2008
                             ----            ----        ----         ----
    Member months
        Fully-insured     1,441,028      1,234,011    3,977,778    3,698,285
        Self-funded         812,780        527,145    1,954,997    1,522,524
           Commercial     2,253,808      1,761,156    5,932,775    5,220,809

        Fully-insured     1,011,294      1,024,093    2,997,800    3,089,384
        Self-funded         590,117              -    1,723,568            -
          Total Reform    1,601,411      1,024,093    4,721,368    3,089,384

        Medicare Advantage  179,878        189,518      565,439      530,395
        Stand-alone PDP      29,330         31,894       88,301       97,374
          Total Medicare    209,208        221,412      653,740      627,769
          Total member
           months         4,064,427      3,006,661   11,307,883    8,937,962

    Medical loss ratio        90.3%          88.6%        90.4%        89.4%
      Commercial              89.8%          90.6%        90.8%        87.1%
      Reform                  91.1%          87.3%        89.9%        91.6%
      Medicare                90.5%          86.4%        90.1%        91.5%

    Operating expense ratio   10.8%          10.2%        10.6%        10.3%

    Managed Care                                As of September 30,
    Membership by Segment                   2009                   2008
                                            ----                   ----
        Fully-insured                     482,579                 411,524
        Self-funded                       263,354                 176,549
          Total Commercial                745,933                 588,073

        Fully-insured                     339,118                 340,710
        Self-funded                       198,296                       -
          Total Reform                    537,414                 340,710

        Medicare Advantage                 59,472                  63,694
        PDP                                 9,818                  10,199
          Total Medicare                   69,290                  73,893

          Total members                 1,352,637               1,002,676

Reaffirming 2009 EPS Guidance

"We are reaffirming our 2009 per-share earnings guidance of $2.03-$2.13, reflecting the fact that our various performance metrics continue to track our expectations," said Ruiz-Comas.

                                                  2009 Range
    Medical enrollment fully-insured
     (member months)                          10.0-10.3 million

    Medical enrollment self-insured
     (member months)                           4.9-5.0 million

    Consolidated operating revenues
     (in billions)                               $1.92-$1.99

    Consolidated loss ratio                      84.8%-85.8%

    Medical loss ratio                           88.8%-89.8%

    Consolidated operating expense
     ratio                                       14.3%-14.7%

    Consolidated operating income (in
     millions)                                   $90.5-$99.0

    Consolidated effective tax rate              21.0%-23.0%

    Earnings per share                           $2.03-$2.13

    Weighted average of diluted shares
     outstanding (in millions)                       29.6

Conference Call and Webcast

Management will host a conference call and webcast Tuesday, November 3 at 9:00 a.m. Eastern Time to discuss its financial results for the third quarter of 2009, as well as expectations for future earnings. To participate, callers within the U.S. and Canada should dial 800-762-8779, and international callers should dial 480-629-9770 about five minutes before the presentation.

To listen to the webcast, participants should visit the Investor Relations section of the Company's Web site at 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 Web site, 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 Web site.

About Triple-S Management Corporation

Triple-S Management Corporation is an independent licensee of the Blue Cross Blue Shield Association. It is the largest managed care company in Puerto Rico, serving approximately 1.3 million members, or about 34% of the population. Triple-S Management also has the exclusive right to use the Blue Cross Blue Shield name and mark throughout Puerto Rico and the U.S. Virgin Islands. With more than 50 years of experience in the industry, Triple-S Management offers a broad portfolio of managed care and related products in the commercial, Medicare, and Reform markets under the Blue Shield brand. In addition to its managed care business, Triple-S Management provides non-Blue Shield branded life and property and casualty insurance in Puerto Rico. The Company is the largest provider of life, accident, and health insurance and the fourth largest provider of property and casualty insurance in its market.

For more information about Triple-S Management, visit or contact

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 and utilization management programs
  • 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.

                           -FINANCIAL TABLES ATTACHED-

                     Condensed Consolidated Balance Sheets
              (Dollar amounts in thousands, except per share data)

                                   September 30, December 31,
                                       2009          2008
                                     ---------     --------

    Investments                     $1,056,305    $1,015,701
    Cash and cash equivalents           54,698        46,095
    Premium and other receivables,
     net                               252,523       237,158
    Deferred policy acquisition
     costs and value of business
     acquired                          134,299       126,347
    Property and equipment, net         66,645        58,448
    Other assets                        68,443        64,710
                                        ------        ------

        Total assets                $1,632,913    $1,548,459
                                    ==========    ==========

     Liabilities and Stockholders' Equity

    Policy liabilities and accruals   $741,113      $690,080
    Accounts payable and accrued
     liabilities                       195,529       203,973
    Borrowings                         168,077       169,307
                                       -------       -------

        Total liabilities            1,104,719     1,063,360
                                     ---------     ---------

    Stockholders' equity:
      Common stock                      29,404        31,148
      Other stockholders equity        498,790       453,951
                                       -------       -------

        Total stockholders' equity     528,194       485,099
                                       -------       -------

        Total liabilities and
         stockholders' equity       $1,632,913    $1,548,459
                                    ==========    ==========

               Condensed Consolidated Statements of Earnings
           (Dollar amounts in thousands, except per share data)

                          For the Three Months   For the Nine Months
                                Ended                  Ended
                             September 30,          September 30,
                         Unaudited  Historical  Unaudited   Historical
                            2009       2008        2009        2008
                         ---------  ----------  ---------   ----------
      Premiums earned,
       net                $477,503   $433,219  $1,396,208  $1,256,775
       service fees          9,797      4,448      29,982      12,081
      Net investment
       income               12,955     14,072      38,856      41,806
                            ------     ------      ------      ------

        Total operating
         revenues          500,255    451,739   1,465,046   1,310,662

      Net realized
       investment losses     2,150     (1,101)     (1,202)     (2,233)
      Net unrealized
       investment gain
       (loss) on trading
       securities            4,860     (3,605)      8,036     (10,806)
      Other income
       (expenses), net          67     (1,147)        392      (1,308)
                                --     ------         ---      ------

        Total revenues     507,332    445,886   1,472,272   1,296,315
                           -------    -------   ---------   ---------

    Benefits and expenses:
      Claims incurred      413,626    365,585   1,206,578   1,070,572
      Operating expenses    71,205     63,572     208,060     185,002
                            ------     ------     -------     -------

        Total operating
         costs             484,831    429,157   1,414,638   1,255,574

      Interest expense       3,338      3,749       9,959      11,348
                             -----      -----       -----      ------

        Total benefits
         and expenses      488,169    432,906   1,424,597   1,266,922
                           -------    -------   ---------   ---------

        Income before
         taxes              19,163     12,980      47,675      29,393
                            ------     ------      ------      ------

    Income tax benefit       1,079      3,509       6,999       6,583
                             -----      -----       -----       -----

        Net income         $18,084     $9,471     $40,676     $22,810
                           =======     ======     =======     =======

    Basic net income
     per share               $0.62      $0.29       $1.37       $0.71

    Diluted earnings
     per share               $0.62      $0.29       $1.37       $0.71

                   Condensed Consolidated Statements of Cash Flows
                (Dollar amounts in thousands, except per share data)

                                                     For the Nine Months Ended
                                                             September 30,
                                                         Unaudited  Historical
                                                           2009        2008
                                                         ---------  ----------

    Net cash provided by (used in) operating activities   $66,654    $(19,894)
                                                          -------    --------

    Cash flows from investing activities:
      Proceeds from investments sold or matured:
        Securities available for sale:
          Fixed maturities sold                           125,951     162,802
          Fixed maturities matured                        151,898      65,088
          Equity securities                                 6,849       4,449
        Securities held to maturity:
          Fixed maturities matured                          6,893      20,107
      Acquisition of investments:
        Securities available for sale:
          Fixed maturities                               (294,628)   (449,515)
          Equity securities                                (3,209)    (17,069)
        Fixed maturity securities held to maturity           (577)       (554)
      Net disbursements for policy loans                     (285)         73
      Capital expenditures                                (14,555)    (12,116)
                                                          -------     -------

            Net cash used in investing activities         (21,663)   (226,735)
                                                          -------    --------

    Cash flows from financing activities:
      Change in outstanding checks in excess of bank
       balances                                           (11,903)     17,992
      Change in short-term borrowings                           -      31,795
      Repayments of long-term borrowings                   (1,230)     (1,229)
      Repurchase and retirement of common stock           (22,034)          -
      Proceeds from policyholder deposits                   3,708       7,156
      Surrenders of policyholder deposits                  (4,929)     (5,793)
      Other                                                     -           6
                                                              ---         ---

            Net cash (used in) provided by financing
             activities                                   (36,388)     49,927
                                                          -------      ------

            Net increase (decrease) in cash and cash
             equivalents                                    8,603    (196,702)

    Cash and cash equivalents, beginning of period         46,095     240,153
                                                           ------     -------

    Cash and cash equivalents, end of period              $54,698     $43,451
                                                          =======     =======

SOURCE Triple-S Management Corporation

SOURCE Triple-S Management Corporation
Copyright©2009 PR Newswire.
All rights reserved

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