SAN JUAN, Puerto Rico,
May 9, 2019 /PRNewswire/ --Triple-S
Management Corporation (NYSE:GTS), a leading managed care company
in Puerto Rico, today announced
its first quarter 2019 results.
Quarterly Consolidated and Other Highlights
- Net income of $34.8 million, or
$1.52 per diluted share, versus net
income of $3.9 million, or
$0.17 per diluted share, in the
prior-year period;
- Adjusted net income of $17.7
million, or $0.77 per diluted
share, versus adjusted net income of $14.1
million, or $0.60 per diluted
share;
- Operating revenues of $787.6
million, a 2.3% increase from the prior-year period,
primarily reflecting higher Managed Care premiums;
- Consolidated loss ratio improved 120 basis points to
81.1%;
- Medical loss ratio ("MLR") improved 140 basis points to
83.6%;
- Consolidated operating income was $31.7
million, compared to consolidated operating income of
$18.1 million in the prior-year
period.
"We opened 2019 with a solid first quarter, driven by sustained
improvement in our core Managed Care segment," said Roberto Garcia-Rodriguez, President and Chief
Executive Officer. "The strength of our brand, the breadth of
our provider network and our competitive product offering led to
double-digit sequential growth in both Medicare Advantage and
Medicaid membership, while our clinical and network management
initiatives continue to drive down the overall medical loss
ratio. Our Life and P&C segments are also
performing quite well, and we remain adequately reserved against
our P&C hurricane-related losses."
"These results reaffirm the soundness of our strategy and
reflect disciplined execution by our associates," added Mr.
Garcia-Rodriguez. "Looking ahead, we will continue investing
in our platforms to reduce the overall cost of care, enhance both
member and provider engagement, expand our market share and build
out an integrated delivery model.
Selected Consolidated Quarterly Details
- Consolidated premiums earned were $768.0
million, up 2.1% 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 as a result of the change in the program's
model and a new entrant to the market in November 2018.
- Consolidated claims incurred were $623.2
million, up 0.7% year-over-year. A consolidated loss ratio
of 81.1% improved 120 basis points from the prior-year period,
mostly due to favorable prior period reserve developments in the
Managed Care segment, and offset in part by the higher target MLR
of the current Medicaid contract and the suspension of the Health
Insurance Providers Fee ("HIP Fee") pass-through.
- Consolidated operating expenses of $132.7 million decreased by $0.4 million, or 0.3%, from the prior-year
period, and the Company's operating expense ratio improved 40 basis
points year-over-year to 17.2%. The decrease in operating expenses
primarily results from the suspension in 2019 of the HIP Fee of
$11.7 million, offset by higher
personnel costs and commission expense, as well as an increase in
the provision for doubtful accounts.
- Consolidated income tax expense was $17.3 million, compared to $0.4 million in the prior-year period, primarily
reflecting the increase in income before taxes in the Managed Care
segment, which has a higher effective tax rate than the Company's
other segments.
Selected Managed Care Segment Quarterly Details
- Managed Care premiums earned were $705.5
million, up 2.7% year over year.
-
- Medicare premiums earned of $332.7
million increased 15.6% from the prior-year period, largely
reflecting an increase of approximately 45,000 member months and
higher average premium rates.
- Commercial premiums earned of $198.5
million declined 0.1% from the prior-year period, mainly
reflecting lower enrollment during the quarter of approximately
8,000 member months and a $3.0
million reduction related to the suspension of the HIP Fee
pass-through in 2019, offset by higher average premium rates.
- Medicaid premiums earned decreased 13.0% from the prior-year
period to $174.3 million, primarily
reflecting lower enrollment of approximately 142,000 member months
due to the commencement of the new Medicaid contract effective
November 1, 2018, combined with a
$3.6 million reduction associated
with the suspension of the HIP Fee pass-through in 2019. As of
March 31, 2019, the Company had
approximately 356,000 Medicaid members enrolled in its Medicaid
program, an increase of 75,000 members over the membership
initially assigned to the Company under the new Medicaid
contract.
The decrease also reflects $3.8
million in premiums earned that the Company recorded in the
prior-year quarter related to its achievement of the previous
contract's quality incentive metrics.
- Reported MLR of 83.6% improved 140 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, Managed Care MLR for this quarter would have been 84.5%, 60
basis points above the prior-year period largely due to the
suspension of the HIP fee pass-through, which accounts for
approximately 50 basis points of the increase.
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. It is maintaining its
full year 2019 guidance for its consolidated claims incurred ratio,
Managed Care MLR and consolidated operating expense ratio, and
adjusting its effective tax rate guidance. More
specifically:
- The Company raised consolidated operating revenue expectations
for 2019 to be between $3.11 billion
and $3.15 billion, which includes
Managed Care premiums earned, net between $2.78 billion and $2.82
billion. The Company's previous outlook was for consolidated
operating revenue between $3.04
billion and $3.08 billion,
which included Managed Care premiums earned, net between
$2.71 billion and $2.75 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 continues to expect its consolidated operating
expense ratio for 2019 to be between 17.6% and 18.6%;
- The Company is adjusting expectations for its effective tax
rate to be between 29.0% and 34.0% 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 25.0% and 30.0%; and
- The Company raised adjusted net income per diluted share
expectations for 2019 to be between $1.90 and $2.10,
compared to its previous outlook for adjusted net income per
diluted share between $1.85 and
$2.05. Adjusted net income per
diluted share guidance does not account for any share repurchase
activity during 2019.
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 March 31, 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 May 23, 2019 by calling 1-844-512-2921 or
1-412-317-6671 and entering passcode 13689843. 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
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
March 31,
2019
|
|
December 31,
2018
|
Assets
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Investments
|
|
$
|
1,591,419
|
|
$
|
1,564,542
|
Cash and cash
equivalents
|
|
|
95,816
|
|
|
117,544
|
Premium and other
receivables, net
|
|
|
660,209
|
|
|
628,444
|
Deferred policy
acquisition costs and value of business acquired
|
|
218,839
|
|
|
215,159
|
Property and
equipment, net
|
|
|
81,514
|
|
|
81,923
|
Other
assets
|
|
|
148,682
|
|
|
152,636
|
|
|
|
|
|
|
|
|
|
|
|
|
Total
assets
|
|
$
|
2,796,479
|
|
$
|
2,760,248
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Liabilities and
Stockholders' Equity
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Policy liabilities
and accruals
|
|
$
|
1,549,807
|
|
$
|
1,600,310
|
Accounts payable and
accrued liabilities
|
|
|
347,428
|
|
|
309,747
|
Long-term
borrowings
|
|
|
28,086
|
|
|
28,883
|
|
|
|
|
|
|
|
|
|
|
|
|
Total
liabilities
|
|
|
1,925,321
|
|
|
1,938,940
|
|
|
|
|
|
|
|
|
|
|
Stockholders'
equity:
|
|
|
|
|
|
|
|
Common
stock
|
|
|
23,107
|
|
|
22,931
|
|
Other stockholders'
equity
|
|
|
848,730
|
|
|
799,053
|
|
|
|
|
|
|
|
|
|
|
|
|
Total Triple-S
Management Corporation stockholders' equity
|
|
871,837
|
|
|
821,984
|
|
|
|
|
|
|
|
|
|
|
|
|
Non-controlling
interest in consolidated subsidiary
|
|
|
(679)
|
|
|
(676)
|
|
|
|
|
|
|
|
|
|
|
|
|
Total stockholders'
equity
|
|
|
871,158
|
|
|
821,308
|
|
|
|
|
|
|
|
|
|
|
|
|
Total liabilities and
stockholders' equity
|
|
$
|
2,796,479
|
|
$
|
2,760,248
|
Exhibit II
Condensed
Consolidated Statements of Earnings
|
(dollar amounts in
thousands, except per share data)
|
Unaudited
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
For the Three
Months Ended
|
|
|
|
|
|
|
|
|
|
March
31,
|
|
|
|
|
|
|
|
|
|
2019
|
|
2018
|
|
Revenues:
|
|
|
|
|
|
|
|
|
|
|
|
Premiums earned,
net
|
|
$
|
768,002
|
|
$
|
752,034
|
|
|
Administrative
service fees
|
|
|
2,632
|
|
|
3,348
|
|
|
Net investment
income
|
|
|
15,376
|
|
|
13,755
|
|
|
Other operating
revenues
|
|
|
1,577
|
|
|
1,071
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Total operating
revenues
|
|
|
787,587
|
|
|
770,208
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Net realized
investment gains on sale of securities
|
|
|
1,315
|
|
|
2,942
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Net unrealized
investment gains (losses) on equity investments
|
|
|
19,669
|
|
|
(16,199)
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Other income,
net
|
|
|
1,169
|
|
|
1,163
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Total
revenues
|
|
|
809,740
|
|
|
758,114
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Benefits and
expenses:
|
|
|
|
|
|
|
|
|
Claims
incurred
|
|
|
|
623,190
|
|
|
618,989
|
|
|
Operating
expenses
|
|
|
132,663
|
|
|
133,134
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Total operating
costs
|
|
|
755,853
|
|
|
752,123
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Interest
expense
|
|
|
1,788
|
|
|
1,690
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Total benefits and
expenses
|
|
|
757,641
|
|
|
753,813
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Income before
taxes
|
|
|
52,099
|
|
|
4,301
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Income tax
expense
|
|
|
17,316
|
|
|
387
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Net income
|
|
|
|
|
|
34,783
|
|
|
3,914
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Less: Net loss
attributable to the non-controlling interest
|
|
|
3
|
|
|
-
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Net income
attributable to Triple-S Management Corporation
|
|
$
|
34,786
|
|
$
|
3,914
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Earnings per share
attributable to Triple-S Management Corporation:
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Basic net income per
share
|
|
$
|
1.53
|
|
$
|
0.17
|
|
|
Diluted net income
per share
|
|
$
|
1.52
|
|
$
|
0.17
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Weighted average of
common shares
|
|
|
22,757,794
|
|
|
23,277,633
|
|
|
Diluted weighted
average of common shares
|
|
|
22,840,274
|
|
|
23,394,997
|
|
Exhibit III
Condensed
Consolidated Statements of Cash Flows
|
(dollar amounts in
thousands)
|
Unaudited
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
For the three
months ended
|
|
|
|
|
|
|
|
March
31,
|
|
|
|
|
|
|
|
2019
|
|
2018
|
|
|
|
|
|
|
|
|
|
|
|
|
Net cash (used in)
provided by operating activities
|
|
$
|
(69,900)
|
|
$
|
130,473
|
|
|
|
|
|
|
|
|
|
|
Cash flows from
investing activities:
|
|
|
|
|
|
|
|
Proceeds from
investments sold or matured:
|
|
|
|
|
|
|
|
|
Securities available
for sale:
|
|
|
|
|
|
|
|
|
|
Fixed maturities
sold
|
|
|
164,997
|
|
|
443,419
|
|
|
|
Fixed maturities
matured/called
|
|
|
12,267
|
|
|
5,368
|
|
|
Securities held to
maturity - fixed maturities matured/called
|
|
|
1,154
|
|
|
1,048
|
|
|
Equity securities
sold
|
|
|
23,123
|
|
|
113,863
|
|
|
Other invested assets
sold
|
|
|
373
|
|
|
845
|
|
Acquisition of
investments:
|
|
|
|
|
|
|
|
|
Securities available
for sale - fixed maturities
|
|
|
(166,626)
|
|
|
(575,694)
|
|
|
Securities held to
maturity - fixed maturities
|
|
|
(539)
|
|
|
(1,212)
|
|
|
Equity
securities
|
|
|
(9,139)
|
|
|
(49,591)
|
|
|
Other invested
assets
|
|
|
(8,546)
|
|
|
(9,683)
|
|
Increase in other
investments
|
|
|
(535)
|
|
|
(4,136)
|
|
Net change in policy
loans
|
|
|
(309)
|
|
|
(185)
|
|
Net capital
expenditures
|
|
|
(2,968)
|
|
|
(4,861)
|
|
|
|
|
|
|
|
|
|
|
|
|
Net cash provided by
(used in) investing activities
|
|
|
13,252
|
|
|
(80,819)
|
|
|
|
|
|
|
|
|
|
|
Cash flows from
financing activities:
|
|
|
|
|
|
|
|
Change in outstanding
checks in excess of bank balances
|
|
|
36,682
|
|
|
(19,992)
|
|
Repayments of
long-term borrowings
|
|
|
(808)
|
|
|
(810)
|
|
Proceeds from
revolving line of credit
|
|
|
-
|
|
|
-
|
|
Repurchase and
retirement of common stock
|
|
|
(1)
|
|
|
(14,259)
|
|
Proceeds from
policyholder deposits
|
|
|
3,607
|
|
|
6,237
|
|
Surrender of
policyholder deposits
|
|
|
(4,560)
|
|
|
(7,161)
|
|
|
|
|
|
|
|
|
|
|
|
|
Net cash provided by
(used in) financing activities
|
|
|
34,920
|
|
|
(35,985)
|
|
|
|
|
|
|
|
|
|
|
|
|
Net (decrease)
increase in cash and cash equivalents
|
|
|
(21,728)
|
|
|
13,669
|
|
|
|
|
|
|
|
|
|
|
|
|
Cash and cash
equivalents, beginning of period
|
|
|
117,544
|
|
|
198,941
|
|
|
|
|
|
|
|
|
|
|
Cash and cash
equivalents, end of period
|
|
$
|
95,816
|
|
$
|
212,610
|
Exhibit IV
Segment Performance Supplemental Information
(Unaudited)
|
|
Three months ended
March 31,
|
|
(dollar amounts in
millions)
|
2019
|
2018
|
Percentage
Change
|
|
Premiums earned,
net:
|
|
|
|
|
|
Managed
Care:
|
|
|
|
|
|
|
Commercial
|
$
198.5
|
$
198.7
|
(0.1%)
|
|
|
|
Medicare
|
332.7
|
287.9
|
15.6%
|
|
|
|
Medicaid
|
174.3
|
200.3
|
(13.0%)
|
|
|
|
|
Total Managed
Care
|
705.5
|
686.9
|
2.7%
|
|
|
Life
Insurance
|
44.2
|
41.5
|
6.5%
|
|
|
Property and
Casualty
|
19.4
|
24.2
|
(19.8%)
|
|
|
Other
|
|
|
(1.1)
|
(0.6)
|
(83.3%)
|
|
|
|
|
|
Consolidated premiums
earned, net
|
$
768.0
|
$
752.0
|
2.1%
|
|
Operating revenues
(loss): 1
|
|
|
|
|
|
Managed
Care
|
$
715.0
|
$
696.1
|
2.7%
|
|
|
Life
Insurance
|
50.8
|
47.5
|
6.9%
|
|
|
Property and
Casualty
|
21.9
|
26.6
|
(17.7%)
|
|
|
Other
|
|
|
(0.1)
|
-
|
0.0%
|
|
|
|
|
|
Consolidated
operating revenues
|
$
787.6
|
$
770.2
|
2.3%
|
|
Operating income:
2
|
|
|
|
|
|
Managed
Care
|
$
22.1
|
$
10.6
|
108.5%
|
|
|
Life
Insurance
|
5.6
|
3.6
|
55.6%
|
|
|
Property and
Casualty
|
3.6
|
3.1
|
16.1%
|
|
|
Other
|
|
|
0.4
|
0.8
|
(50.0%)
|
|
|
|
|
|
Consolidated
operating income
|
$
31.7
|
$
18.1
|
75.1%
|
|
Operating margin:
3
|
|
|
|
|
|
Managed
Care
|
3.1%
|
1.5%
|
160 bp
|
|
|
Life
Insurance
|
11.0%
|
7.6%
|
340 bp
|
|
|
Property and
Casualty
|
16.4%
|
11.7%
|
470 bp
|
|
|
Consolidated
|
4.0%
|
2.4%
|
160 bp
|
|
Depreciation and
amortization expense
|
$
3.5
|
$
3.4
|
2.9%
|
|
|
|
|
|
|
|
|
|
|
|
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
March 31,
|
(Unaudited)
|
|
2019
|
2018
|
Member months
enrollment:
|
|
|
|
Commercial:
|
|
|
|
|
Fully-insured
|
953,052
|
961,290
|
|
|
Self-insured
|
362,490
|
449,778
|
|
|
|
Total
Commercial
|
1,315,542
|
1,411,068
|
|
Medicare
Advantage
|
|
|
|
383,608
|
338,340
|
|
Medicaid
|
|
1,029,736
|
1,171,345
|
|
|
|
|
Total member
months
|
2,728,886
|
2,920,753
|
Claim liabilities
(in millions)
|
$
397.3
|
$
402.4
|
Days claim
payable
|
61
|
62
|
Premium
PMPM:
|
|
|
|
Managed
Care
|
$
298.13
|
$
277.99
|
|
|
Commercial
|
208.28
|
206.70
|
|
|
Medicare
Advantage
|
867.29
|
850.92
|
|
|
Medicaid
|
169.27
|
171.00
|
Medical loss
ratio:
|
83.6%
|
85.0%
|
|
Commercial
|
82.9%
|
81.3%
|
|
Medicare
Advantage
|
80.6%
|
84.6%
|
|
Medicaid
|
|
90.3%
|
89.2%
|
Adjusted medical loss
ratio: 1
|
84.5%
|
83.9%
|
|
Commercial
|
83.6%
|
82.7%
|
|
Medicare
Advantage
|
82.0%
|
82.1%
|
|
Medicaid
|
|
90.4%
|
87.5%
|
Operating expense
ratio:
|
|
|
|
Consolidated
|
17.2%
|
17.6%
|
|
Managed
Care
|
14.5%
|
14.7%
|
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 March
31,
|
|
|
2019
|
2018
|
Members:
|
|
|
|
|
Commercial:
|
|
|
|
|
Fully-insured
|
|
318,523
|
319,208
|
|
Self-insured
|
|
118,677
|
148,688
|
|
Total
Commercial
|
|
437,200
|
467,896
|
|
Medicare
Advantage
|
|
|
|
|
|
128,090
|
112,080
|
|
Medicaid
|
|
|
355,694
|
394,454
|
|
Total
members
|
|
920,984
|
974,430
|
Exhibit V
Reconciliation of Non-GAAP Financial Measures
|
|
|
|
|
|
Adjusted Net
Income (Loss)
|
(Unaudited)
|
|
Three months
ended
March 31,
|
(dollar amounts in
millions)
|
2019
|
2018
|
|
Net income
|
|
$
34.8
|
$
3.9
|
|
Less
adjustments:
|
|
|
|
|
Net realized
investment gains, net of tax
|
1.1
|
2.3
|
|
|
Unrealized gains
(losses) on equity investments
|
15.7
|
(13.0)
|
|
|
Private equity
investment income, net of tax
|
0.3
|
0.5
|
|
|
|
Adjusted net
income
|
$
17.7
|
$
14.1
|
|
|
|
Diluted adjusted net
income per share
|
$
0.77
|
$
0.60
|
|
|
|
|
|
|
|
|
|
|
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.
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