e10vq
UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
FORM 10-Q
(Mark One)
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þ |
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QUARTERLY REPORT PURSUANT TO SECTION 13 OR 15(D) OF THE SECURITIES EXCHANGE ACT OF 1934 |
For the quarterly period ended September 30, 2010
or
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o |
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TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(D) OF THE SECURITIES EXCHANGE ACT OF 1934 |
For the transition period from to
COMMISSION FILE NUMBER: 001-33865
Triple-S Management Corporation
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Puerto Rico
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(State or other jurisdiction of |
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66-0555678 |
incorporation or organization)
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(I.R.S. Employer Identification No.) |
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1441 F.D. Roosevelt Avenue
San Juan, Puerto Rico
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00920 |
(Address of principal executive offices)
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(Zip code) |
(787) 749-4949
(Registrants telephone number, including area code)
Not applicable
(Former name, former address and former fiscal year, if changed since last report)
Indicate by check mark whether the registrant (1) has filed all reports required to be filed
by Section 13 or 15(d) of the Securities Exchange Act of 1934 during the preceding 12 months (or
for such shorter period that the registrant was required to file such reports), and (2) has been
subject to such filing requirements for the past 90 days.
þ Yes o No
Indicate by check mark whether the registrant has submitted electronically and posted on its
corporate Web site, if any, every Interactive Data File required to be submitted and posted
pursuant to Rule 405 of Regulation S-T (§232.405 of this chapter) during the preceding 12 months
(or for such shorter period that the registrant was required to submit and post such files).
o Yes o No
Indicate by check mark whether the registrant is a large accelerated filer, an accelerated
filer, a non-accelerated filer, or a smaller reporting company. See definitions of large
accelerated filer, accelerated filer and smaller reporting company in Rule 12b-2 of the
Exchange Act.
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Large accelerated filer o
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Accelerated filer þ
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Non-accelerated filer o
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Smaller reporting company o |
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(Do not check if a smaller reporting company) |
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Indicate by check mark whether the registrant is a shell company (as defined in Rule 12b-2 of
the Exchange Act). o Yes þ No
Indicate the number of shares outstanding of each of the issuers classes of common stock, as
of the latest practicable date.
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Title of each class |
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Outstanding at October 31, 2010 |
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Common Stock Class A, $1.00 par value |
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9,042,809 |
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Common Stock Class B, $1.00 par value |
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20,101,005 |
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Triple-S Management Corporation
FORM 10-Q
For the Quarter Ended September 30, 2010
Table of Contents
2
Part I Financial Information
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Item 1. Financial Statements |
Triple-S Management Corporation
Consolidated Balance Sheets (Unaudited)
(Dollar amounts in thousands, except per share data)
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September 30, |
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December 31, |
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2010 |
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2009 |
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Assets |
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Investments and cash: |
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Equity securities held for
trading, at fair value |
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$ |
46,228 |
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$ |
43,909 |
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Securities available for
sale, at fair value: |
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Fixed maturities |
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1,023,469 |
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918,977 |
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Equity securities |
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73,241 |
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64,689 |
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Securities held to
maturity, at amortized
cost: |
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Fixed maturities |
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15,266 |
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15,794 |
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Policy loans |
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6,064 |
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5,940 |
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Cash and cash equivalents |
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50,679 |
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40,376 |
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Total investments and cash |
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1,214,947 |
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1,089,685 |
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Premiums and other
receivables, net |
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315,092 |
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272,932 |
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Deferred policy acquisition
costs and value of business
acquired |
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142,444 |
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139,917 |
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Property and equipment, net |
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74,170 |
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68,803 |
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Deferred tax asset |
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28,869 |
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37,551 |
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Other assets |
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30,084 |
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39,816 |
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Total assets |
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$ |
1,805,606 |
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$ |
1,648,704 |
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Liabilities and Stockholders Equity |
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Claim liabilities |
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423,819 |
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360,446 |
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Liability for future policy
benefits |
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232,727 |
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222,619 |
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Unearned premiums |
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92,489 |
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108,342 |
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Policyholder deposits |
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48,215 |
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47,563 |
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Liability to Federal
Employees Health Benefits
Program (FEHBP) |
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16,029 |
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13,002 |
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Accounts payable and accrued
liabilities |
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139,640 |
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139,161 |
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Deferred tax liability |
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15,215 |
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11,088 |
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Borrowings |
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166,124 |
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167,667 |
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Liability for pension benefits |
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36,709 |
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41,044 |
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Total liabilities |
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1,170,967 |
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1,110,932 |
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Stockholders equity: |
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Common stock Class A, $1 par value.
Authorized 100,000,000 shares; issued
and outstanding 9,042,809 at September
30, 2010 and December 31, 2009 |
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9,043 |
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9,043 |
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Common stock Class B, $1 par value.
Authorized 100,000,000 shares; issued
and outstanding 20,101,005 and
20,110,391 shares at September 30,
2010 and December 31, 2009,
respectively |
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20,101 |
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20,110 |
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Additional paid-in capital |
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160,224 |
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159,303 |
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Retained earnings |
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407,629 |
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360,892 |
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Accumulated other
comprehensive income
(loss) |
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37,642 |
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(11,576 |
) |
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Total stockholders equity |
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634,639 |
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537,772 |
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Total liabilities and
stockholders equity |
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$ |
1,805,606 |
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$ |
1,648,704 |
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See accompanying notes to unaudited consolidated financial statements.
3
Triple-S Management Corporation
Consolidated Statements of Earnings (Unaudited)
(Dollar amounts in thousands, except per share data)
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Three months ended |
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Nine months ended |
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September 30, |
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September 30, |
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2010 |
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2009 |
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2010 |
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2009 |
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Revenues: |
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Premiums earned, net |
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$ |
496,511 |
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$ |
476,269 |
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$ |
1,493,449 |
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$ |
1,390,778 |
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Administrative service fees |
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10,195 |
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9,797 |
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34,859 |
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29,982 |
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Net investment income |
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12,794 |
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12,955 |
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37,888 |
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38,856 |
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Total operating revenues |
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519,500 |
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499,021 |
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1,566,196 |
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1,459,616 |
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Net realized investment gains (losses): |
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Total other-than-temporary impairment losses on securities |
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(316 |
) |
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(240 |
) |
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(2,932 |
) |
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(5,953 |
) |
Net realized gains, excluding other-than-temporary impairment |
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losses on securities |
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3 |
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2,390 |
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2,673 |
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4,751 |
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Total net realized investment gains (losses) |
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(313 |
) |
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2,150 |
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(259 |
) |
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(1,202 |
) |
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Net unrealized investment gain on trading securities |
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4,611 |
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4,860 |
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631 |
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8,036 |
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Other income, net |
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576 |
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67 |
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404 |
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392 |
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Total revenues |
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524,374 |
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506,098 |
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1,566,972 |
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1,466,842 |
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Benefits and expenses: |
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Claims incurred |
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421,514 |
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412,392 |
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1,272,180 |
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1,201,148 |
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Operating expenses |
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74,111 |
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71,205 |
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227,702 |
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208,060 |
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Total operating costs |
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495,625 |
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483,597 |
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1,499,882 |
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1,409,208 |
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Interest expense |
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3,026 |
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3,338 |
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9,626 |
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9,959 |
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Total benefits and expenses |
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498,651 |
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486,935 |
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1,509,508 |
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1,419,167 |
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Income before taxes |
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25,723 |
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19,163 |
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57,464 |
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47,675 |
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Income tax expense (benefit): |
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Current |
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6,040 |
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2,096 |
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14,461 |
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|
11,637 |
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Deferred |
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(805 |
) |
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(1,017 |
) |
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(3,734 |
) |
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(4,638 |
) |
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Total income taxes |
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5,235 |
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1,079 |
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10,727 |
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6,999 |
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Net income |
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$ |
20,488 |
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|
$ |
18,084 |
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$ |
46,737 |
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$ |
40,676 |
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Basic net income per share |
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$ |
0.70 |
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$ |
0.62 |
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$ |
1.61 |
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$ |
1.37 |
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Diluted net income per share |
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$ |
0.70 |
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$ |
0.62 |
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$ |
1.60 |
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$ |
1.37 |
|
See accompanying notes to unaudited consolidated financial statements.
4
Triple-S Management Corporation
Consolidated Statements of Stockholders Equity and Comprehensive Income (Loss) (Unaudited)
(Dollar amounts in thousands, except per share data)
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2010 |
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2009 |
|
Balance at January 1 |
|
$ |
537,772 |
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|
$ |
485,099 |
|
Share-based compensation |
|
|
1,301 |
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|
3,231 |
|
Grant of restricted Class B common stock |
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15 |
|
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|
27 |
|
Repurchase and retirement of common stock |
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(404 |
) |
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(22,034 |
) |
Comprehensive income (loss): |
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Net income |
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46,737 |
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|
40,676 |
|
Net unrealized change in fair value of available for sale securities, net of taxes |
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|
48,332 |
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|
20,299 |
|
Defined benefit pension plan: |
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Actuarial loss, net |
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1,089 |
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|
1,103 |
|
Prior service credit, net |
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(203 |
) |
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(207 |
) |
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Total comprehensive income |
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95,955 |
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|
61,871 |
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Balance at September 30 |
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$ |
634,639 |
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$ |
528,194 |
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|
See accompanying notes to unaudited consolidated financial statements.
5
Triple-S Management Corporation
Consolidated Statements of Cash Flows (Unaudited)
(Dollar amounts in thousands, except per share data)
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Nine months ended |
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September 30, |
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2010 |
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2009 |
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Cash flows from operating activities: |
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Net income |
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$ |
46,737 |
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|
$ |
40,676 |
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Adjustments to reconcile net income to net cash
provided by operating activities: |
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Depreciation and amortization |
|
|
10,605 |
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|
6,358 |
|
Net amortization of investments |
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|
2,399 |
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|
|
544 |
|
Provision for doubtful receivables |
|
|
6,721 |
|
|
|
10,070 |
|
Deferred tax benefit |
|
|
(3,734 |
) |
|
|
(4,638 |
) |
Net realized investment loss on sale of securities |
|
|
259 |
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|
1,202 |
|
Net unrealized gain on trading securities |
|
|
(631 |
) |
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|
(8,036 |
) |
Share-based compensation |
|
|
1,316 |
|
|
|
3,258 |
|
Proceeds from trading securities sold: |
|
|
|
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|
|
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Equity securities |
|
|
3,441 |
|
|
|
2,923 |
|
Acquisition of securities in trading portfolio: |
|
|
|
|
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Equity securities |
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(4,931 |
) |
|
|
(3,206 |
) |
(Increase) decrease in assets: |
|
|
|
|
|
|
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|
Premium and other receivables, net |
|
|
(42,574 |
) |
|
|
(25,214 |
) |
Deferred policy acquisition costs and value of business acquired |
|
|
(2,527 |
) |
|
|
(7,952 |
) |
Other deferred taxes |
|
|
7,347 |
|
|
|
(11,150 |
) |
Other assets |
|
|
3,673 |
|
|
|
7,904 |
|
Increase (decrease) in liabilities: |
|
|
|
|
|
|
|
|
Claim liabilities |
|
|
63,373 |
|
|
|
54,087 |
|
Liability for future policy benefits |
|
|
10,108 |
|
|
|
11,747 |
|
Unearned premiums |
|
|
(15,853 |
) |
|
|
(14,148 |
) |
Policyholder deposits |
|
|
487 |
|
|
|
568 |
|
Liability to FEHBP |
|
|
3,027 |
|
|
|
2,858 |
|
Accounts payable and accrued liabilities |
|
|
(2,223 |
) |
|
|
(1,197 |
) |
|
|
|
|
|
|
|
Net cash provided by operating activities |
|
|
87,020 |
|
|
|
66,654 |
|
|
|
|
|
|
|
|
(Continued)
6
Triple-S Management Corporation
Consolidated Statements of Cash Flows (Unaudited)
(Dollar amounts in thousands, except per share data)
|
|
|
|
|
|
|
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|
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|
Nine months ended |
|
|
|
September 30, |
|
|
|
2010 |
|
|
2009 |
|
Cash flows from investing activities: |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Proceeds from investments sold or matured: |
|
|
|
|
|
|
|
|
Securities available for sale: |
|
|
|
|
|
|
|
|
Fixed maturities sold |
|
$ |
48,193 |
|
|
$ |
125,951 |
|
Fixed maturities matured/called |
|
|
97,067 |
|
|
|
151,898 |
|
Equity securities |
|
|
16,791 |
|
|
|
6,849 |
|
Securities held to maturity: |
|
|
|
|
|
|
|
|
Fixed maturities matured/called |
|
|
1,852 |
|
|
|
6,893 |
|
Acquisition of investments: |
|
|
|
|
|
|
|
|
Securities available for sale: |
|
|
|
|
|
|
|
|
Fixed maturities |
|
|
(199,809 |
) |
|
|
(294,628 |
) |
Equity securities |
|
|
(22,436 |
) |
|
|
(3,209 |
) |
Fixed maturity securities held to maturity |
|
|
(1,050 |
) |
|
|
(577 |
) |
Net outflows for policy loans |
|
|
(124 |
) |
|
|
(285 |
) |
Net capital expenditures |
|
|
(13,678 |
) |
|
|
(14,555 |
) |
|
|
|
|
|
|
|
Net cash used in investing activities |
|
|
(73,194 |
) |
|
|
(21,663 |
) |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Cash flows from financing activities: |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Change in outstanding checks in excess of bank balances |
|
|
(2,458 |
) |
|
|
(11,903 |
) |
Repayments of long-term borrowings |
|
|
(1,230 |
) |
|
|
(1,230 |
) |
Repurchase and retirement of common stock |
|
|
|
|
|
|
(22,034 |
) |
Proceeds from policyholder deposits |
|
|
7,740 |
|
|
|
3,708 |
|
Surrenders of policyholder deposits |
|
|
(7,575 |
) |
|
|
(4,929 |
) |
|
|
|
|
|
|
|
Net cash used in financing activities |
|
|
(3,523 |
) |
|
|
(36,388 |
) |
|
|
|
|
|
|
|
Net increase in cash and cash equivalents |
|
|
10,303 |
|
|
|
8,603 |
|
|
|
|
|
|
|
|
|
|
Cash and cash equivalents: |
|
|
|
|
|
|
|
|
Beginning of period |
|
|
40,376 |
|
|
|
46,095 |
|
|
|
|
|
|
|
|
End of period |
|
$ |
50,679 |
|
|
$ |
54,698 |
|
|
|
|
|
|
|
|
See accompanying notes to unaudited consolidated financial statements.
7
Triple-S Management Corporation
Notes to Consolidated Financial Statements
(Dollar amounts in thousands, except per share data)
(Unaudited)
(1) Basis of Presentation
The accompanying consolidated interim financial statements prepared by Triple-S Management
Corporation and its subsidiaries are unaudited. In this filing, the Corporation, the Company,
TSM, we, us and our refer to Triple-S Management Corporation and its subsidiaries. The
consolidated interim financial statements do not include all of the information and the footnotes
required by accounting principles generally accepted in the U.S. (GAAP) for complete financial
statements. These consolidated interim financial statements should be read in conjunction with the
audited consolidated financial statements included in the Corporations Annual Report on Form 10-K
for the year ended December 31, 2009.
Certain amounts in the 2009 consolidated statement of earnings were reclassified to conform to
the 2010 presentation.
In the opinion of management, all adjustments, consisting of normal recurring adjustments
necessary for a fair statement of such consolidated interim financial statements have been
included. The results of operations for the three months and nine months ended September 30, 2010
are not necessarily indicative of the results for the full year.
(2) Recent Accounting Standards
In April 2010, the FASB issued guidance to address the classification of an employee
share-based payment award with an exercise price denominated in the currency of a market in which
the underlying equity security trades. The guidance clarifies that a share-based payment award
with an exercise price denominated in the currency of a market in which a substantial portion of
the entitys equity securities trades should not be considered to contain a condition that is not a
market, performance, or service condition. Therefore, such an award should not be classified as a
liability if it otherwise qualifies as equity. This guidance is effective for fiscal years and
interim periods within those fiscal years, beginning on or after December 15, 2010. We do not
expect the adoption of this guidance to have an impact on our financial position or results of
operations.
In October 2010, the FASB issued guidance to address diversity in practice regarding the
interpretation of which costs relating to the acquisition of new or renewal insurance contracts
qualify for deferral. This guidance specifies that the following costs incurred in the acquisition
of new and renewal contracts should be capitalized: (1) Incremental direct costs of contract
acquisition. Incremental direct costs are those costs that result directly from and are essential
to the contract transaction and would not have been incurred by the insurance entity had the
contract transaction not occurred. (2) Certain costs related directly to the following acquisition
activities performed by the insurer for the contract: a. Underwriting, b. Policy issuance and
processing, c. Medical and inspection, and c. Sales force contract selling. Advertising costs
should be included in deferred acquisition costs only if the capitalization criteria in the
direct-response advertising guidance in Subtopic 340-20, Other Assets and Deferred Costs
Capitalized Advertising Costs, are met. This guidance is effective for fiscal years and interim
periods within those fiscal years, beginning on or after December 15, 2011. We do not expect the
adoption of this guidance to have a significant impact on our financial position or results of
operations.
Other than the accounting pronouncement disclosed above, there were no other new accounting
pronouncements issued during the nine months ended September 30, 2010 that could have a material
impact on the Corporations financial position, operating results or financials statement
disclosures.
(3) Segment Information
The operations of the Corporation are conducted principally through three business segments:
Managed Care, Life Insurance, and Property and Casualty Insurance. The Corporation 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 Corporation
calculates operating income or loss as operating revenues less operating costs.
8
Triple-S Management Corporation
Notes to Consolidated Financial Statements
(Dollar amounts in thousands, except per share data)
(Unaudited)
Our Managed Care segment is engaged in the sale of managed care products to the Commercial,
Medicare and Medicaid market sectors. Through the Medicaid market sector, the government of Puerto
Rico (the government) provides health coverage to medically indigent citizens in Puerto Rico, as
defined by the laws of the Commonwealth of Puerto Rico. Up to September 30, 2010, our Managed Care
subsidiary, Triple-S Salud, Inc. (TSS) provided managed care services to Medicaid members in the
North and Southwest regions on a fully-insured basis and in the Metro-North region on an
Administrative Service Only (ASO) basis. The current contracts between the Government and Triple-S
for the provision of services to the Medicaid population of Puerto Rico expired by their own terms
on September 30, 2010, thus effective October 1st, 2010 we no longer provide services to
these members.
The following tables summarize the operations by major operating segment for the three months
and nine months ended September 30, 2010 and 2009:
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Three months ended |
|
|
Nine months ended |
|
|
|
September 30, |
|
|
September 30, |
|
|
|
2010 |
|
|
2009 |
|
|
2010 |
|
|
2009 |
|
Operating revenues: |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Managed Care: |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Premiums earned, net |
|
$ |
445,514 |
|
|
$ |
427,332 |
|
|
$ |
1,340,261 |
|
|
$ |
1,244,033 |
|
Administrative service fees |
|
|
10,195 |
|
|
|
9,798 |
|
|
|
34,859 |
|
|
|
29,983 |
|
Intersegment premiums /service fees |
|
|
1,649 |
|
|
|
1,533 |
|
|
|
4,717 |
|
|
|
4,481 |
|
Net investment income |
|
|
5,225 |
|
|
|
5,435 |
|
|
|
15,262 |
|
|
|
15,953 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Total managed care |
|
|
462,583 |
|
|
|
444,098 |
|
|
|
1,395,099 |
|
|
|
1,294,450 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Life Insurance: |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Premiums earned, net |
|
|
26,606 |
|
|
|
24,645 |
|
|
|
78,410 |
|
|
|
74,198 |
|
Intersegment premiums |
|
|
99 |
|
|
|
108 |
|
|
|
293 |
|
|
|
293 |
|
Net investment income |
|
|
4,467 |
|
|
|
4,093 |
|
|
|
12,913 |
|
|
|
12,480 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Total life insurance |
|
|
31,172 |
|
|
|
28,846 |
|
|
|
91,616 |
|
|
|
86,971 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Property and Casualty Insurance: |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Premiums earned, net |
|
|
24,391 |
|
|
|
24,293 |
|
|
|
74,778 |
|
|
|
72,547 |
|
Intersegment premiums |
|
|
153 |
|
|
|
153 |
|
|
|
460 |
|
|
|
460 |
|
Net investment income |
|
|
2,594 |
|
|
|
2,998 |
|
|
|
8,197 |
|
|
|
8,783 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Total property and casualty insurance |
|
|
27,138 |
|
|
|
27,444 |
|
|
|
83,435 |
|
|
|
81,790 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Other segments intersegment service
revenues * |
|
|
12,452 |
|
|
|
13,889 |
|
|
|
40,127 |
|
|
|
39,003 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Total business segments |
|
|
533,345 |
|
|
|
514,277 |
|
|
|
1,610,277 |
|
|
|
1,502,214 |
|
TSM operating revenues from external sources |
|
|
508 |
|
|
|
427 |
|
|
|
1,516 |
|
|
|
1,639 |
|
Elimination of intersegment premiums |
|
|
(1,901 |
) |
|
|
(1,794 |
) |
|
|
(5,470 |
) |
|
|
(5,234 |
) |
Elimination of intersegment service fees |
|
|
(12,452 |
) |
|
|
(13,889 |
) |
|
|
(40,127 |
) |
|
|
(39,003 |
) |
|
|
|
|
|
|
|
|
|
|
|
|
|
Consolidated operating revenues |
|
$ |
519,500 |
|
|
$ |
499,021 |
|
|
$ |
1,566,196 |
|
|
$ |
1,459,616 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
* |
|
Includes segments that are not required to be reported separately. These segments include the
data processing services organization as well as the third-party administrator of managed care
services. |
9
Triple-S Management Corporation
Notes to Consolidated Financial Statements
(Dollar amounts in thousands, except per share data)
(Unaudited)
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Three months ended |
|
|
Nine months ended |
|
|
|
September 30, |
|
|
September 30, |
|
|
|
2010 |
|
|
2009 |
|
|
2010 |
|
|
2009 |
|
Operating income: |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Managed care |
|
$ |
16,417 |
|
|
|
10,098 |
|
|
$ |
47,532 |
|
|
|
32,080 |
|
Life insurance |
|
|
4,529 |
|
|
|
3,992 |
|
|
|
13,055 |
|
|
|
10,938 |
|
Property and casualty insurance |
|
|
2,242 |
|
|
|
245 |
|
|
|
3,311 |
|
|
|
4,394 |
|
Other segments * |
|
|
476 |
|
|
|
451 |
|
|
|
974 |
|
|
|
813 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Total business segments |
|
|
23,664 |
|
|
|
14,786 |
|
|
|
64,872 |
|
|
|
48,225 |
|
TSM operating revenues from external sources |
|
|
508 |
|
|
|
427 |
|
|
|
1,516 |
|
|
|
1,638 |
|
TSM unallocated operating expenses |
|
|
(2,678 |
) |
|
|
(2,178 |
) |
|
|
(7,102 |
) |
|
|
(6,648 |
) |
Elimination of TSM intersegment charges |
|
|
2,381 |
|
|
|
2,389 |
|
|
|
7,028 |
|
|
|
7,193 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Consolidated operating income |
|
|
23,875 |
|
|
|
15,424 |
|
|
|
66,314 |
|
|
|
50,408 |
|
Consolidated net realized investment gains (losses) |
|
|
(313 |
) |
|
|
2,150 |
|
|
|
(259 |
) |
|
|
(1,202 |
) |
Consolidated net unrealized gain on trading
securities |
|
|
4,611 |
|
|
|
4,860 |
|
|
|
631 |
|
|
|
8,036 |
|
Consolidated interest expense |
|
|
(3,026 |
) |
|
|
(3,338 |
) |
|
|
(9,626 |
) |
|
|
(9,959 |
) |
Consolidated other income, net |
|
|
576 |
|
|
|
67 |
|
|
|
404 |
|
|
|
392 |
|
|
|
|
|
|
Consolidated income before taxes |
|
$ |
25,723 |
|
|
|
19,163 |
|
|
$ |
57,464 |
|
|
|
47,675 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Depreciation expense: |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Managed care |
|
|
2,767 |
|
|
|
1,364 |
|
|
|
8,157 |
|
|
|
4,092 |
|
Life insurance |
|
|
173 |
|
|
|
181 |
|
|
|
510 |
|
|
|
491 |
|
Property and casualty insurance |
|
|
485 |
|
|
|
378 |
|
|
|
1,290 |
|
|
|
1,128 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Total business segments |
|
|
3,425 |
|
|
|
1,923 |
|
|
|
9,957 |
|
|
|
5,711 |
|
TSM depreciation expense |
|
|
216 |
|
|
|
216 |
|
|
|
648 |
|
|
|
647 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Consolidated depreciation expense |
|
$ |
3,641 |
|
|
|
2,139 |
|
|
$ |
10,605 |
|
|
|
6,358 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
* |
|
Includes segments that are not required to be reported separately. These segments include the
data processing services organization as well as the third-party administrator of managed care
services. |
10
Triple-S Management Corporation
Notes to Consolidated Financial Statements
(Dollar amounts in thousands, except per share data)
(Unaudited)
|
|
|
|
|
|
|
|
|
|
|
September 30, |
|
|
December 31, |
|
|
|
2010 |
|
|
2009 |
|
Assets: |
|
|
|
|
|
|
|
|
Managed care |
|
$ |
850,114 |
|
|
$ |
746,674 |
|
Life insurance |
|
|
538,427 |
|
|
|
487,290 |
|
Property and casualty insurance |
|
|
353,416 |
|
|
|
351,793 |
|
Other segments * |
|
|
12,594 |
|
|
|
14,193 |
|
|
|
|
|
|
|
|
Total business segments |
|
|
1,754,551 |
|
|
|
1,599,950 |
|
|
|
|
|
|
|
|
Unallocated amounts related to TSM: |
|
|
|
|
|
|
|
|
Cash, cash equivalents, and investments |
|
|
55,817 |
|
|
|
39,029 |
|
Property and equipment, net |
|
|
20,929 |
|
|
|
21,577 |
|
Other assets |
|
|
16,170 |
|
|
|
4,780 |
|
|
|
|
|
|
|
|
|
|
|
92,916 |
|
|
|
65,386 |
|
|
|
|
|
|
|
|
Elimination entries-intersegment
receivables and others |
|
|
(41,861 |
) |
|
|
(16,632 |
) |
|
|
|
|
|
|
|
Consolidated total assets |
|
$ |
1,805,606 |
|
|
$ |
1,648,704 |
|
|
|
|
|
|
|
|
|
|
|
* |
|
Includes segments that are not required to be reported separately. These segments include the
data processing services organization as well as the third-party administrator of managed care
services. |
11
Triple-S Management Corporation
Notes to Consolidated Financial Statements
(Dollar amounts in thousands, except per share data)
(Unaudited)
(4) Investment in Securities
The amortized cost for debt securities and cost for equity securities, gross unrealized gains,
gross unrealized losses, and estimated fair value for trading, available-for-sale and
held-to-maturity securities by major security type and class of security at September 30, 2010 and
December 31, 2009, were as follows:
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
September 30, 2010 |
|
|
|
|
|
|
|
Gross |
|
|
Gross |
|
|
|
|
|
|
|
|
|
|
unrealized |
|
|
unrealized |
|
|
Estimated |
|
|
|
Cost |
|
|
gains |
|
|
losses |
|
|
fair value |
|
Trading securities: |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Equity securities |
|
$ |
43,763 |
|
|
$ |
7,844 |
|
|
$ |
(5,379 |
) |
|
$ |
46,228 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
December 31, 2009 |
|
|
|
|
|
|
|
Gross |
|
|
Gross |
|
|
|
|
|
|
|
|
|
|
unrealized |
|
|
unrealized |
|
|
Estimated |
|
|
|
Cost |
|
|
gains |
|
|
losses |
|
|
fair value |
|
Trading securities: |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Equity securities |
|
$ |
42,075 |
|
|
$ |
7,064 |
|
|
$ |
(5,230 |
) |
|
$ |
43,909 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
September 30, 2010 |
|
|
|
|
|
|
|
Gross |
|
|
Gross |
|
|
|
|
|
|
Amortized |
|
|
unrealized |
|
|
unrealized |
|
|
Estimated |
|
|
|
cost |
|
|
gains |
|
|
losses |
|
|
fair value |
|
Securities available for sale: |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Fixed maturities: |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Obligations of government-
sponsored enterprises |
|
$ |
188,641 |
|
|
$ |
13,087 |
|
|
$ |
|
|
|
$ |
201,728 |
|
U.S. Treasury securities and
obligations of U.S.
government instrumentalities |
|
|
47,621 |
|
|
|
8,345 |
|
|
|
|
|
|
|
55,966 |
|
Obligations of the
Commonwealth of Puerto Rico
and its instrumentalities |
|
|
160,529 |
|
|
|
4,926 |
|
|
|
(164 |
) |
|
|
165,291 |
|
Municipal securities |
|
|
200,290 |
|
|
|
13,541 |
|
|
|
(62 |
) |
|
|
213,769 |
|
Corporate bonds |
|
|
102,925 |
|
|
|
13,701 |
|
|
|
|
|
|
|
116,626 |
|
Residential mortgage-backed securities |
|
|
13,912 |
|
|
|
843 |
|
|
|
(2 |
) |
|
|
14,753 |
|
Collateralized mortgage obligations |
|
|
248,036 |
|
|
|
7,574 |
|
|
|
(274 |
) |
|
|
255,336 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Total fixed maturities |
|
|
961,954 |
|
|
|
62,017 |
|
|
|
(502 |
) |
|
|
1,023,469 |
|
Equity securities: |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Common stocks |
|
|
900 |
|
|
|
2,786 |
|
|
|
|
|
|
|
3,686 |
|
Preferred stocks |
|
|
4,298 |
|
|
|
73 |
|
|
|
(526 |
) |
|
|
3,845 |
|
Perpetual preferred stocks |
|
|
1,000 |
|
|
|
|
|
|
|
(79 |
) |
|
|
921 |
|
Mutual funds |
|
|
60,819 |
|
|
|
5,114 |
|
|
|
(1,144 |
) |
|
|
64,789 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Total equity securities |
|
|
67,017 |
|
|
|
7,973 |
|
|
|
(1,749 |
) |
|
|
73,241 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Total |
|
$ |
1,028,971 |
|
|
$ |
69,990 |
|
|
$ |
(2,251 |
) |
|
$ |
1,096,710 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
12
Triple-S Management Corporation
Notes to Consolidated Financial Statements
(Dollar amounts in thousands, except per share data)
(Unaudited)
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
December 31, 2009 |
|
|
|
|
|
|
|
Gross |
|
|
Gross |
|
|
|
|
|
|
Amortized |
|
|
unrealized |
|
|
unrealized |
|
|
Estimated |
|
|
|
cost |
|
|
gains |
|
|
losses |
|
|
fair value |
|
Securities available for sale: |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Fixed maturities: |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Obligations of government-
sponsored enterprises |
|
$ |
252,513 |
|
|
$ |
2,240 |
|
|
$ |
(3,325 |
) |
|
$ |
251,428 |
|
U.S. Treasury securities and
obligations of U.S.
government instrumentalities |
|
|
48,190 |
|
|
|
3,148 |
|
|
|
|
|
|
|
51,338 |
|
Obligations of the
Commonwealth of Puerto Rico
and its instrumentalities |
|
|
154,754 |
|
|
|
3,113 |
|
|
|
(1,919 |
) |
|
|
155,948 |
|
Municipal securities |
|
|
107,441 |
|
|
|
1,117 |
|
|
|
(1,851 |
) |
|
|
106,707 |
|
Corporate bonds |
|
|
102,547 |
|
|
|
3,546 |
|
|
|
(728 |
) |
|
|
105,365 |
|
Residential mortgage-backed securities |
|
|
16,605 |
|
|
|
677 |
|
|
|
(1 |
) |
|
|
17,281 |
|
Collateralized mortgage obligations |
|
|
229,312 |
|
|
|
4,237 |
|
|
|
(2,639 |
) |
|
|
230,910 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Total fixed maturities |
|
|
911,362 |
|
|
|
18,078 |
|
|
|
(10,463 |
) |
|
|
918,977 |
|
Equity securities: |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Common stocks |
|
|
4,074 |
|
|
|
3,435 |
|
|
|
|
|
|
|
7,509 |
|
Preferred stocks |
|
|
4,000 |
|
|
|
|
|
|
|
(1,325 |
) |
|
|
2,675 |
|
Perpetual preferred stocks |
|
|
2,849 |
|
|
|
|
|
|
|
(270 |
) |
|
|
2,579 |
|
Mutual funds |
|
|
50,608 |
|
|
|
4,150 |
|
|
|
(2,832 |
) |
|
|
51,926 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Total equity securities |
|
|
61,531 |
|
|
|
7,585 |
|
|
|
(4,427 |
) |
|
|
64,689 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Total |
|
$ |
972,893 |
|
|
$ |
25,663 |
|
|
$ |
(14,890 |
) |
|
$ |
983,666 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
September 30, 2010 |
|
|
|
|
|
|
|
Gross |
|
|
Gross |
|
|
|
|
|
|
Amortized |
|
|
unrealized |
|
|
unrealized |
|
|
Estimated |
|
|
|
cost |
|
|
gains |
|
|
losses |
|
|
fair value |
|
Securities held to maturity: |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Obligations of government-
sponsored enterprises |
|
$ |
2,303 |
|
|
$ |
219 |
|
|
$ |
|
|
|
$ |
2,522 |
|
U.S. Treasury securities and
obligations of U.S.
government instrumentalities |
|
|
1,479 |
|
|
|
348 |
|
|
|
|
|
|
|
1,827 |
|
Corporate bonds |
|
|
9,347 |
|
|
|
532 |
|
|
|
|
|
|
|
9,879 |
|
Residential mortgage-backed securities |
|
|
897 |
|
|
|
39 |
|
|
|
|
|
|
|
936 |
|
Certificates of deposit |
|
|
1,240 |
|
|
|
|
|
|
|
|
|
|
|
1,240 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Total |
|
$ |
15,266 |
|
|
$ |
1,138 |
|
|
$ |
|
|
|
$ |
16,404 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
13
Triple-S Management Corporation
Notes to Consolidated Financial Statements
(Dollar amounts in thousands, except per share data)
(Unaudited)
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
December 31, 2009 |
|
|
|
|
|
|
|
Gross |
|
|
Gross |
|
|
|
|
|
|
Amortized |
|
|
unrealized |
|
|
unrealized |
|
|
Estimated |
|
|
|
cost |
|
|
gains |
|
|
losses |
|
|
fair value |
|
Securities held to maturity: |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Obligations of government-
sponsored enterprises |
|
$ |
925 |
|
|
$ |
6 |
|
|
$ |
|
|
|
$ |
931 |
|
U.S. Treasury securities and
obligations of U.S.
government instrumentalities |
|
|
3,786 |
|
|
|
132 |
|
|
|
|
|
|
|
3,918 |
|
Corporate bonds |
|
|
9,063 |
|
|
|
534 |
|
|
|
|
|
|
|
9,597 |
|
Residential mortgage-backed securities |
|
|
1,256 |
|
|
|
25 |
|
|
|
(1 |
) |
|
|
1,280 |
|
Certificates of deposit |
|
|
764 |
|
|
|
|
|
|
|
|
|
|
|
764 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Total |
|
$ |
15,794 |
|
|
$ |
697 |
|
|
$ |
(1 |
) |
|
$ |
16,490 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Gross unrealized losses on investment securities and the estimated fair value of the related
securities, aggregated by investment category and length of time that individual securities have
been in a continuous unrealized loss position as of September 30, 2010 and December 31, 2009 were
as follows:
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
September 30, 2010 |
|
|
|
Less than 12 months |
|
|
12 months or longer |
|
|
Total |
|
|
|
|
|
|
|
Gross |
|
|
|
|
|
|
|
|
|
|
Gross |
|
|
|
|
|
|
|
|
|
|
Gross |
|
|
|
|
|
|
Estimated |
|
|
Unrealized |
|
|
Number of |
|
|
Estimated |
|
|
Unrealized |
|
|
Number of |
|
|
Estimated |
|
|
Unrealized |
|
|
Number of |
|
|
|
Fair Value |
|
|
Loss |
|
|
Securities |
|
|
Fair Value |
|
|
Loss |
|
|
Securities |
|
|
Fair Value |
|
|
Loss |
|
|
Securities |
|
Securites available for sale: |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Fixed maturities: |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Obligations of the
Commonwealth of Puerto
Rico and its instrumentalities |
|
$ |
8,811 |
|
|
$ |
(20 |
) |
|
|
4 |
|
|
$ |
3,709 |
|
|
$ |
(144 |
) |
|
|
3 |
|
|
$ |
12,520 |
|
|
$ |
(164 |
) |
|
|
7 |
|
Municipal securities |
|
|
776 |
|
|
|
(62 |
) |
|
|
1 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
776 |
|
|
|
(62 |
) |
|
|
1 |
|
Residential mortgage-backed
securities |
|
|
12 |
|
|
|
(1 |
) |
|
|
1 |
|
|
|
36 |
|
|
|
(1 |
) |
|
|
1 |
|
|
|
48 |
|
|
|
(2 |
) |
|
|
2 |
|
Collateralized mortgage
obligations |
|
|
24,159 |
|
|
|
(249 |
) |
|
|
5 |
|
|
|
1,947 |
|
|
|
(25 |
) |
|
|
1 |
|
|
|
26,106 |
|
|
|
(274 |
) |
|
|
6 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Total fixed maturities |
|
|
33,758 |
|
|
|
(332 |
) |
|
|
11 |
|
|
|
5,692 |
|
|
|
(170 |
) |
|
|
5 |
|
|
|
39,450 |
|
|
|
(502 |
) |
|
|
16 |
|
Equity securities: |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Preferred stocks |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
3,474 |
|
|
|
(526 |
) |
|
|
1 |
|
|
|
3,474 |
|
|
|
(526 |
) |
|
|
1 |
|
Perpetual preferred stocks |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
920 |
|
|
|
(79 |
) |
|
|
1 |
|
|
|
920 |
|
|
|
(79 |
) |
|
|
1 |
|
Mutual funds |
|
|
8,521 |
|
|
|
(491 |
) |
|
|
5 |
|
|
|
9,825 |
|
|
|
(653 |
) |
|
|
7 |
|
|
|
18,346 |
|
|
|
(1,144 |
) |
|
|
12 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Total equity securities |
|
|
8,521 |
|
|
|
(491 |
) |
|
|
5 |
|
|
|
14,219 |
|
|
|
(1,258 |
) |
|
|
9 |
|
|
|
22,740 |
|
|
|
(1,749 |
) |
|
|
14 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Total for securities available for sale |
|
$ |
42,279 |
|
|
$ |
(823 |
) |
|
|
16 |
|
|
$ |
19,911 |
|
|
$ |
(1,428 |
) |
|
|
14 |
|
|
$ |
62,190 |
|
|
$ |
(2,251 |
) |
|
|
30 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
14
Triple-S Management Corporation
Notes to Consolidated Financial Statements
(Dollar amounts in thousands, except per share data)
(Unaudited)
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
December 31, 2009 |
|
|
|
Less than 12 months |
|
|
12 months or longer |
|
|
Total |
|
|
|
|
|
|
|
Gross |
|
|
|
|
|
|
|
|
|
|
Gross |
|
|
|
|
|
|
|
|
|
|
Gross |
|
|
|
|
|
|
Estimated |
|
|
Unrealized |
|
|
Number of |
|
|
Estimated |
|
|
Unrealized |
|
|
Number of |
|
|
Estimated |
|
|
Unrealized |
|
|
Number of |
|
|
|
Fair Value |
|
|
Loss |
|
|
Securities |
|
|
Fair Value |
|
|
Loss |
|
|
Securities |
|
|
Fair Value |
|
|
Loss |
|
|
Securities |
|
Securites available for sale: |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Fixed maturities: |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Obligations of government-
sponsored enterprises |
|
$ |
110,602 |
|
|
$ |
(2,264 |
) |
|
|
21 |
|
|
$ |
25,468 |
|
|
$ |
(1,061 |
) |
|
|
5 |
|
|
$ |
136,070 |
|
|
$ |
(3,325 |
) |
|
|
26 |
|
Obligations of the
Commonwealth of Puerto
Rico and its instrumentalities |
|
|
12,944 |
|
|
|
(201 |
) |
|
|
10 |
|
|
|
58,866 |
|
|
|
(1,718 |
) |
|
|
22 |
|
|
|
71,810 |
|
|
|
(1,919 |
) |
|
|
32 |
|
Municipal securities |
|
|
62,292 |
|
|
|
(1,841 |
) |
|
|
39 |
|
|
|
173 |
|
|
|
(10 |
) |
|
|
1 |
|
|
|
62,465 |
|
|
|
(1,851 |
) |
|
|
40 |
|
Corporate bonds |
|
|
10,997 |
|
|
|
(215 |
) |
|
|
4 |
|
|
|
7,975 |
|
|
|
(513 |
) |
|
|
6 |
|
|
|
18,972 |
|
|
|
(728 |
) |
|
|
10 |
|
Residential mortgage-backed
securities |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
36 |
|
|
|
(1 |
) |
|
|
1 |
|
|
|
36 |
|
|
|
(1 |
) |
|
|
1 |
|
Collateralized mortgage
obligations |
|
|
101,265 |
|
|
|
(1,732 |
) |
|
|
21 |
|
|
|
7,171 |
|
|
|
(907 |
) |
|
|
10 |
|
|
|
108,436 |
|
|
|
(2,639 |
) |
|
|
31 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Total fixed maturities |
|
|
298,100 |
|
|
|
(6,253 |
) |
|
|
95 |
|
|
|
99,689 |
|
|
|
(4,210 |
) |
|
|
45 |
|
|
|
397,789 |
|
|
|
(10,463 |
) |
|
|
140 |
|
Equity securities: |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Preferred stocks |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
2,675 |
|
|
|
(1,325 |
) |
|
|
1 |
|
|
|
2,675 |
|
|
|
(1,325 |
) |
|
|
1 |
|
Perpetual preferred stocks |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
730 |
|
|
|
(270 |
) |
|
|
1 |
|
|
|
730 |
|
|
|
(270 |
) |
|
|
1 |
|
Mutual funds |
|
|
9,994 |
|
|
|
(907 |
) |
|
|
4 |
|
|
|
21,667 |
|
|
|
(1,925 |
) |
|
|
15 |
|
|
|
31,661 |
|
|
|
(2,832 |
) |
|
|
19 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Total equity securities |
|
|
9,994 |
|
|
|
(907 |
) |
|
|
4 |
|
|
|
25,072 |
|
|
|
(3,520 |
) |
|
|
17 |
|
|
|
35,066 |
|
|
|
(4,427 |
) |
|
|
21 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Total for securities available for sale |
|
$ |
308,094 |
|
|
$ |
(7,160 |
) |
|
|
99 |
|
|
$ |
124,761 |
|
|
$ |
(7,730 |
) |
|
|
62 |
|
|
$ |
432,855 |
|
|
$ |
(14,890 |
) |
|
|
161 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Securities held to maturity: |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Residential mortgage-backed
securities |
|
$ |
|
|
|
$ |
|
|
|
|
|
|
|
$ |
55 |
|
|
$ |
(1 |
) |
|
|
1 |
|
|
$ |
55 |
|
|
$ |
(1 |
) |
|
|
1 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
The Corporation regularly monitors and evaluates the difference between the cost and
estimated fair value of investments. For investments with a fair value below cost, the process
includes evaluating: (1) the length of time and the extent to which the estimated fair value has
been less than amortized cost for fixed maturity securities, or cost for equity securities, (2) the
financial condition, near-term and long-term prospects for the issuer, including relevant industry
conditions and trends, and implications of rating agency actions, (3) the Corporations intent to
sell or the likelihood of a required sale prior to recovery, (4) the recoverability of principal
and interest for fixed maturity securities, or cost for equity securities, and (5) other factors,
as applicable. This process is not exact and further requires consideration of risks such as
credit and interest rate risks. Consequently, if an investments cost exceeds its estimated fair
value solely due to changes in interest rates, other-than temporary impairment may not be
appropriate. Due to the subjective nature of the Corporations analysis, along with the judgment
that must be applied in the analysis, it is possible that the Corporation could reach a different
conclusion whether or not to impair a security if it had access to additional information about the
investee. Additionally, it is possible that the investees ability to meet future contractual
obligations may be different than what the Corporation determined during its analysis, which may
lead to a different impairment conclusion in future periods. If after monitoring and analyzing
impaired securities, the Corporation determines that a decline in the estimated fair value of any
available-for-sale security below cost is other-than-temporary, the carrying amount of equity
securities is reduced to its fair value and of fixed maturity securities is reduced by the credit
component of the other-than-temporary impairment. When a decline in the estimated fair value of
any held-to-maturity security below cost is deemed other-than-temporary, the carrying amount of the
security is reduced by the other-than-temporary impairment. The new cost basis of an impaired
security is not adjusted for subsequent increases in estimated fair value. In periods subsequent
to the recognition of an other-than-temporary impairment, the impaired security is accounted for as
if it had been purchased on the measurement date of the impairment. For debt securities, the
discount (or reduced premium) based on the new cost basis may be accreted into net investment
income in future periods based on prospective changes in cash flow estimates, to reflect
adjustments to the effective yield.
The Corporations process for identifying and reviewing invested assets for other-than
temporary impairments during any quarter includes the following:
|
|
Identification and evaluation of securities that have possible
indications of other-than-temporary impairment, which includes an
analysis of all investments with gross unrealized investment losses
that represent 20% or more of their cost and all investments with an
unrealized loss greater than $50. |
15
Triple-S Management Corporation
Notes to Consolidated Financial Statements
(Dollar amounts in thousands, except per share data)
(Unaudited)
|
|
Review and evaluation of any other security based on the investees
current financial condition, liquidity, near-term recovery prospects,
implications of rating agency actions, the outlook for the business
sectors in which the investee operates and other factors. This
evaluation is in addition to the evaluation of those securities with a
gross unrealized investment loss representing 20% or more of their
cost. |
|
|
|
Consideration of evidential matter, including an evaluation of factors
or triggers that may or may not cause individual investments to
qualify as having other-than-temporary impairments; and |
|
|
|
Determination of the status of each analyzed security as
other-than-temporary or not, with documentation of the rationale for
the decision. |
The Corporation continually reviews its investment portfolios under the Corporations
impairment review policy. Given the current market conditions and the significant judgments
involved, there is a continuing risk that further declines in fair value may occur and additional
material other-than-temporary impairments may be recorded in future periods.
Obligations of States of the United States and Political Subdivisions of the States, and
Obligations of the Commonwealth of Puerto Rico and its Instrumentalities: The unrealized losses on
the Corporations investments in obligations of states of the U.S. and political subdivisions of
the states, and in obligations of the Commonwealth of Puerto Rico and its instrumentalities were
mainly caused by fluctuations in interest rates and general market conditions. The contractual
terms of these investments do not permit the issuer to settle the securities at a price less than
the par value of the investment. In addition, most of these investments have investment grade
ratings. Because the decline in fair value is attributable to changes in interest rates and not
credit quality; because the Corporation does not intend to sell the investments; it is not more
likely than not that the Corporation will be required to sell the investments before recovery of
their amortized cost basis, which may be maturity; and because the Corporation expects to collect
all contractual cash flows, these investments are not considered other-than-temporarily impaired.
Residential Mortgage-Backed Securities and Collateralized Mortgage Obligations: The
unrealized losses on investments in residential mortgage-backed securities and collateralized
mortgage obligations were mostly caused by fluctuations in interest rates and credit spreads. The
contractual cash flows of these securities, other than private CMOs, are guaranteed by a
U.S. government-sponsored enterprise. The Corporation also has investments in private CMOs. Any
loss in these securities is determined according to the seniority level of each tranche, with the
least senior (or most junior), typically the unrated residual tranche, taking any initial loss.
The investment grade credit rating of our securities reflects the seniority of the securities that
the Corporation owns. Because the decline in fair value is attributable to changes in interest
rates and not credit quality, the Corporation does not intend to sell the investments and it is not
more likely than not that the Corporation will be required to sell the investments before recovery
of their amortized cost basis, which may be maturity, and because the Corporation expects to
collect all contractual cash flows, these investments are not considered other-than-temporarily
impaired.
Preferred Stocks: This particular instrument has a specified maturity, the issuers capital
ratios are above regulatory levels, the issuer has continued dividend payments on this instrument
and interest payments on all of its outstanding debt instruments, the issuer does not have the
ability to call the security at a price lower than its stated value, the Corporation expects to
collect all contractual cash flows, the estimated fair value of this security has improved
significantly during the nine months ended September 30, 2010, the Corporation does not have the
intent to sell the investment, and it is not more likely than not that the Corporation will be
required to sell the investment before market price recovery or maturity, this investment is not
considered other-than-temporarily impaired.
Perpetual Preferred Stocks: This security has experienced a significant improvement in value
during the nine months ended September 30, 2010. The issuers capital ratios are above regulatory
levels, analysts target price is above market price and book value as of June 30, 2010, the
Corporation does not have the intent to sell the investment, and the Corporation has the intent and
ability to hold the investments until a market price recovery, this investment is not considered
other-than-temporarily impaired.
16
Triple-S Management Corporation
Notes to Consolidated Financial Statements
(Dollar amounts in thousands, except per share data)
(Unaudited)
Mutual Funds: The unrealized losses in the Corporations investment in mutual funds are in
several mutual funds that in turn invested in fixed income securities and in broad market indices
securities. We evaluated for other-than-temporary impairment these securities as follows:
|
|
Mutual funds invested in fixed income securities: The unrealized loss
of each position in this category represents 10% or less of its book
value. The Corporation evaluated the invested assets that compose the
funds, which are mostly fixed income obligations of the Puerto Rico
and U.S. government or its agencies. In Puerto Rico these mutual
funds are exempt and have a higher dividend yield than investments in
other Puerto Rico securities. As these mutual funds are invested in
fixed income securities, they are susceptible to fluctuations in
interest rates as well as supply and demand. Earlier in the year the
mutual funds showed a relative underperformance when compared to the
underlying assets because of a decrease in supply and demand, which
caused the market price to be closer to the net asset value compared
to where this relationship had been historically. Lately, the demand
for these mutual funds has increased because of the high yield the
funds offer. Because the current valuations are close to the funds
underlying assets, the funds underlying assets are mostly on
investment grade fixed income securities (mostly U.S. and Puerto Rico
government and its agencies, which have been affected by general
market conditions), and the Corporation has the intent and ability to
hold the investments until a market price recovery, these investments
are not considered other-than-temporarily impaired. |
|
|
|
Broad market indices securities: The unrealized loss of each position
in this category is less than 3% of its book value and is the result
of fluctuations in equity markets. These positions are designed to
mirror the behavior of the Standard &Poors 500 and the Russell 1000
Value indices and have been with an unrealized loss for a period less
than six months. Because there has been an improvement in the market
price of these positions in the period subsequent to September 30,
2010, these positions have been with an unrealized loss for a short
time period, and the Corporation has the intent and ability to hold
the investments until a market price recovery, these investments are
not considered other-than-temporarily impaired. |
Maturities of investment securities classified as available for sale and held to maturity at
September 30, 2010 were as follows:
|
|
|
|
|
|
|
|
|
|
|
Amortized |
|
|
Estimated |
|
|
|
cost |
|
|
fair value |
|
Securities available for sale: |
|
|
|
|
|
|
|
|
Due in one year or less |
|
$ |
10,749 |
|
|
$ |
10,892 |
|
Due after one year through five years |
|
|
113,498 |
|
|
|
118,928 |
|
Due after five years through ten years |
|
|
229,039 |
|
|
|
247,098 |
|
Due after ten years |
|
|
346,720 |
|
|
|
376,462 |
|
Residential mortgage-backed securities |
|
|
13,912 |
|
|
|
14,753 |
|
Collateralized mortgage obligations |
|
|
248,036 |
|
|
|
255,336 |
|
|
|
|
|
|
|
|
|
|
$ |
961,954 |
|
|
$ |
1,023,469 |
|
|
|
|
|
|
|
|
Securities held to maturity: |
|
|
|
|
|
|
|
|
Due in one year or less |
|
$ |
1,240 |
|
|
$ |
1,240 |
|
Due after one year through five years |
|
|
9,347 |
|
|
|
9,879 |
|
Due after five years through ten years |
|
|
510 |
|
|
|
513 |
|
Due after ten years |
|
|
3,272 |
|
|
|
3,836 |
|
Residential mortgage-backed securities |
|
|
897 |
|
|
|
936 |
|
|
|
|
|
|
|
|
|
|
$ |
15,266 |
|
|
$ |
16,404 |
|
|
|
|
|
|
|
|
Expected maturities may differ from contractual maturities because some issuers have the right
to call or prepay obligations with or without call or prepayment penalties.
17
Triple-S Management Corporation
Notes to Consolidated Financial Statements
(Dollar amounts in thousands, except per share data)
(Unaudited)
Information regarding realized and unrealized gains and losses from investments for the three
months and nine months ended September 30, 2010 and 2009 is as follows:
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Three months ended |
|
|
Nine months ended |
|
|
|
September 30, |
|
|
September 30, |
|
|
|
2010 |
|
|
2009 |
|
|
2010 |
|
|
2009 |
|
Realized gains (losses): |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Fixed maturity securities: |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Securities available for sale: |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Gross gains from sales |
|
$ |
|
|
|
$ |
65 |
|
|
$ |
69 |
|
|
$ |
3,122 |
|
Gross losses from sales |
|
|
(148 |
) |
|
|
|
|
|
|
(272 |
) |
|
|
(3 |
) |
Gross losses from other-than-temporary impairments |
|
|
|
|
|
|
(240 |
) |
|
|
(95 |
) |
|
|
(1,393 |
) |
|
|
|
|
|
|
|
|
|
|
|
|
|
Total debt securities |
|
|
(148 |
) |
|
|
(175 |
) |
|
|
(298 |
) |
|
|
1,726 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Equity securities: |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Trading securities: |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Gross gains from sales |
|
|
110 |
|
|
|
107 |
|
|
|
935 |
|
|
|
416 |
|
Gross losses from sales |
|
|
(212 |
) |
|
|
(104 |
) |
|
|
(741 |
) |
|
|
(823 |
) |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
(102 |
) |
|
|
3 |
|
|
|
194 |
|
|
|
(407 |
) |
|
|
|
|
|
|
|
|
|
|
|
|
|
Securities available for sale: |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Gross gains from sales |
|
|
273 |
|
|
|
2,322 |
|
|
|
3,259 |
|
|
|
2,322 |
|
Gross losses from sales |
|
|
(19 |
) |
|
|
|
|
|
|
(576 |
) |
|
|
(283 |
) |
Gross losses from other-than-temporary impairments |
|
|
(317 |
) |
|
|
|
|
|
|
(2,838 |
) |
|
|
(4,560 |
) |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
(63 |
) |
|
|
2,322 |
|
|
|
(155 |
) |
|
|
(2,521 |
) |
|
|
|
|
|
|
|
|
|
|
|
|
|
Total equity securities |
|
|
(165 |
) |
|
|
2,325 |
|
|
|
39 |
|
|
|
(2,928 |
) |
|
|
|
|
|
|
|
|
|
|
|
|
|
Net realized (losses) gains on securities |
|
$ |
(313 |
) |
|
$ |
2,150 |
|
|
$ |
(259 |
) |
|
$ |
(1,202 |
) |
|
|
|
|
|
|
|
|
|
|
|
|
|
The other-than-temporary impairments on fixed maturity securities are attributable to credit losses.
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Three months ended |
|
|
Nine months ended |
|
|
|
September 30, |
|
|
September 30, |
|
|
|
2010 |
|
|
2009 |
|
|
2010 |
|
|
2009 |
|
Changes in net unrealized gains (losses): |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Recognized in income: |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Equity securities trading |
|
$ |
4,611 |
|
|
$ |
4,860 |
|
|
$ |
631 |
|
|
$ |
8,036 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Recognized in accumulated other comprehensive income: |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Fixed maturities available for sale |
|
|
14,376 |
|
|
|
21,393 |
|
|
|
53,900 |
|
|
|
21,044 |
|
Equity securities available for sale |
|
|
5,011 |
|
|
|
3,346 |
|
|
|
3,066 |
|
|
|
2,837 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
$ |
19,387 |
|
|
$ |
24,739 |
|
|
$ |
56,966 |
|
|
$ |
23,881 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Not recognized in the consolidated financial statements: |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Fixed maturities held to maturity |
|
$ |
93 |
|
|
$ |
90 |
|
|
$ |
442 |
|
|
$ |
(441 |
) |
|
|
|
|
|
|
|
|
|
|
|
|
|
The deferred tax liability/asset on unrealized gains and losses, respectively, recognized
in accumulated other comprehensive income/ (loss) during the nine months ended September 30, 2010
and 2009 aggregated to $10,315 and $3,582, respectively.
As of September 30, 2010 and December 31, 2009, no individual investment in securities
exceeded 10% of stockholders equity.
18
Triple-S Management Corporation
Notes to Consolidated Financial Statements
(Dollar amounts in thousands, except per share data)
(Unaudited)
Components of net investment income were as follows:
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Three months ended |
|
|
Nine months ended |
|
|
|
September 30, |
|
|
September 30, |
|
|
|
2010 |
|
|
2009 |
|
|
2010 |
|
|
2009 |
|
Fixed maturities |
|
$ |
11,707 |
|
|
$ |
11,629 |
|
|
$ |
34,303 |
|
|
$ |
34,498 |
|
Equity securities |
|
|
756 |
|
|
|
891 |
|
|
|
2,595 |
|
|
|
2,984 |
|
Policy loans |
|
|
113 |
|
|
|
105 |
|
|
|
330 |
|
|
|
302 |
|
Cash equivalents and interest-bearing deposits |
|
|
58 |
|
|
|
127 |
|
|
|
160 |
|
|
|
485 |
|
Other |
|
|
160 |
|
|
|
203 |
|
|
|
500 |
|
|
|
587 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Total |
|
$ |
12,794 |
|
|
$ |
12,955 |
|
|
$ |
37,888 |
|
|
$ |
38,856 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
(5) Premiums and Other Receivables, Net
Premiums and other receivables, net as of September 30, 2010 and December 31, 2009 were as
follows:
|
|
|
|
|
|
|
|
|
|
|
September 30, |
|
|
December 31, |
|
|
|
2010 |
|
|
2009 |
|
Premium |
|
$ |
142,397 |
|
|
$ |
98,429 |
|
Self-funded group receivables |
|
|
81,634 |
|
|
|
70,315 |
|
FEHBP |
|
|
11,198 |
|
|
|
10,297 |
|
Agents balances |
|
|
28,187 |
|
|
|
37,888 |
|
Accrued interest |
|
|
10,278 |
|
|
|
9,287 |
|
Reinsurance recoverable |
|
|
47,303 |
|
|
|
43,951 |
|
Other |
|
|
26,050 |
|
|
|
27,999 |
|
|
|
|
|
|
|
|
|
|
|
347,047 |
|
|
|
298,166 |
|
|
|
|
|
|
|
|
Less allowance for doubtful receivables: |
|
|
|
|
|
|
|
|
Premiums |
|
|
24,884 |
|
|
|
20,280 |
|
Other |
|
|
7,071 |
|
|
|
4,954 |
|
|
|
|
|
|
|
|
|
|
|
31,955 |
|
|
|
25,234 |
|
|
|
|
|
|
|
|
Total premiums and other receivables |
|
$ |
315,092 |
|
|
$ |
272,932 |
|
|
|
|
|
|
|
|
19
Triple-S Management Corporation
Notes to Consolidated Financial Statements
(Dollar amounts in thousands, except per share data)
(Unaudited)
(6) Claim Liabilities
The activity in the total claim liabilities for the three months and nine months ended
September 30, 2010 and 2009 is as follows:
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Three months ended |
|
|
Nine months ended |
|
|
|
September 30, |
|
|
September 30, |
|
|
|
2010 |
|
|
2009 |
|
|
2010 |
|
|
2009 |
|
Claim liabilities at beginning of period |
|
$ |
411,410 |
|
|
$ |
363,914 |
|
|
$ |
360,446 |
|
|
$ |
323,710 |
|
Reinsurance recoverable on claim liabilities |
|
|
(33,069 |
) |
|
|
(30,154 |
) |
|
|
(30,712 |
) |
|
|
(30,432 |
) |
|
|
|
|
|
|
|
|
|
|
|
|
|
Net claim liabilities at beginning of period |
|
|
378,341 |
|
|
|
333,760 |
|
|
|
329,734 |
|
|
|
293,278 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Incurred claims and loss-adjustment expenses: |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Current period insured events |
|
|
417,642 |
|
|
|
407,651 |
|
|
|
1,259,518 |
|
|
|
1,194,365 |
|
Prior period insured events |
|
|
671 |
|
|
|
1,731 |
|
|
|
4,006 |
|
|
|
(2,872 |
) |
|
|
|
|
|
|
|
|
|
|
|
|
|
Total |
|
|
418,313 |
|
|
|
409,382 |
|
|
|
1,263,524 |
|
|
|
1,191,493 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Payments of losses and loss-adjustment expenses: |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Current period insured events |
|
|
383,961 |
|
|
|
353,243 |
|
|
|
951,570 |
|
|
|
903,574 |
|
Prior period insured events |
|
|
22,016 |
|
|
|
44,728 |
|
|
|
251,011 |
|
|
|
236,026 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Total |
|
|
405,977 |
|
|
|
397,971 |
|
|
|
1,202,581 |
|
|
|
1,139,600 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Net claim liabilities at end of period |
|
|
390,677 |
|
|
|
345,171 |
|
|
|
390,677 |
|
|
|
345,171 |
|
Reinsurance recoverable on claim liabilities |
|
|
33,142 |
|
|
|
32,626 |
|
|
|
33,142 |
|
|
|
32,626 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Claim liabilities at end of period |
|
$ |
423,819 |
|
|
$ |
377,797 |
|
|
$ |
423,819 |
|
|
$ |
377,797 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
As a result of differences between actual amounts and estimates of insured events in prior
periods, the amounts included as incurred claims for prior period insured events differ from
anticipated claims incurred.
The amount of incurred claims and loss-adjustment expenses for prior period insured events for
the three months and nine months ended September 30, 2010 and for the three months ended September
30, 2009 is due primarily to higher than expected utilization trends. The credit in the incurred
claims and loss-adjustment expenses for prior period insured events for the nine months ended
September 30, 2009 is due primarily to better than expected utilization trends.
Reinsurance recoverable on unpaid claims is reported as premium and other receivables, net in
the accompanying consolidated financial statements. The claims incurred disclosed in this table
exclude the change in the liability for future policy benefits expense, which amounted to $3,201
and $8,656, during the three months and nine months ended September 30, 2010, respectively. The
change in the liability for future policy benefits during the three months and nine months ended
September 30, 2009 amount to $3,010 and $9,655, respectively.
(7) Borrowings
During September 2010, the Company entered into an agreement to purchase $25.0 million of its
$60.0 million, 6.60% unsecured note payable with a settlement date of October 1, 2010.
20
Triple-S Management Corporation
Notes to Consolidated Financial Statements
(Dollar amounts in thousands, except per share data)
(Unaudited)
(8) Fair Value Measurements
Assets recorded at fair value in the consolidated balance sheets are categorized based upon
the level of judgment associated with the inputs used to measure their fair value. Level inputs,
as defined by current accounting guidance for fair value measurements and disclosures, are as
follows:
|
|
|
Level Input: |
|
Input Definition: |
Level 1
|
|
Inputs are unadjusted, quoted prices for identical assets or
liabilities in active markets at the measurement date. |
|
|
|
Level 2
|
|
Inputs other than quoted prices included in Level 1 that are
observable for the asset or liability through corroboration
with market data at the measurement date. |
|
|
|
Level 3
|
|
Unobservable inputs that reflect managements best estimate
of what market participants would use in pricing the asset or
liability at the measurement date. |
The fair value information of financial instruments in the accompanying consolidated financial
statements was determined as follows:
(i) Cash and Cash Equivalents
The carrying amount approximates fair value because of the short-term nature of such instruments.
(ii) Investment in Securities
The fair value of investment securities is estimated based on quoted market prices for those
or similar investments. Additional information pertinent to the estimated fair value of investment
in securities is included in note 4.
(iii) Policy Loans
Policy loans have no stated maturity dates and are part of the related insurance contract. The
carrying amount of policy loans approximates fair value because their interest rate is reset
periodically in accordance with current market rates.
(iv) Receivables, Accounts Payable and Accrued Liabilities
The carrying amount of receivables, accounts payable and accrued liabilities approximates fair
value because they mature and should be collected or paid within 12 months after September 30,
2010.
(v) Policyholder Deposits
The fair value of policyholder deposits is the amount payable on demand at the reporting date,
and accordingly, the carrying value amount approximates fair value.
(vi) Borrowings
The carrying amounts and fair value of the Corporations borrowings are as follows:
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
September 30, 2010 |
|
|
December 31, 2009 |
|
|
|
Carrying |
|
|
Fair |
|
|
Carrying |
|
|
Fair |
|
|
|
amount |
|
|
value |
|
|
amount |
|
|
value |
|
Loans payable to bank |
|
$ |
21,437 |
|
|
$ |
21,437 |
|
|
$ |
22,667 |
|
|
$ |
22,667 |
|
6.3% senior unsecured notes payable |
|
|
50,000 |
|
|
|
49,725 |
|
|
|
50,000 |
|
|
|
48,000 |
|
6.6% senior unsecured notes payable |
|
|
59,687 |
|
|
|
59,025 |
|
|
|
60,000 |
|
|
|
57,420 |
|
6.7% senior unsecured notes payable |
|
|
35,000 |
|
|
|
34,458 |
|
|
|
35,000 |
|
|
|
33,320 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Totals |
|
$ |
166,124 |
|
|
$ |
164,645 |
|
|
$ |
167,667 |
|
|
$ |
161,407 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
21
Triple-S Management Corporation
Notes to Consolidated Financial Statements
(Dollar amounts in thousands, except per share data)
(Unaudited)
The carrying amount of the loans payable to bank approximates fair value due to its floating
interest-rate structure. The fair value of the senior unsecured notes payable was determined using
broker quotations. The carrying amount of short-term borrowings approximates fair value because of
the short-term nature of such instruments.
(vii) Derivative Instruments
Current market pricing models were used to estimate fair value of structured notes agreements.
Fair values were determined using market quotations provided by outside securities consultants or
prices provided by market makers using observable inputs.
The following table summarizes fair value measurements by level at September 30, 2010 and
December 31, 2009 for assets measured at fair value on a recurring basis:
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
September 30, 2010 |
|
|
|
Level 1 |
|
|
Level 2 |
|
|
Level 3 |
|
|
Total |
|
Equity securities held for trading |
|
$ |
46,228 |
|
|
$ |
|
|
|
$ |
|
|
|
$ |
46,228 |
|
Securities available for sale: |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Fixed maturity securities |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Obligations of government-sponsored |
|
|
|
|
|
|
201,728 |
|
|
|
|
|
|
|
201,728 |
|
U.S. Treasury securities and obligations of U.S
government instrumentalities |
|
|
55,966 |
|
|
|
|
|
|
|
|
|
|
|
55,966 |
|
Obligations of the Commonwealth of Puerto
and its instrumentalities |
|
|
|
|
|
|
165,291 |
|
|
|
|
|
|
|
165,291 |
|
Municipal securities |
|
|
|
|
|
|
213,769 |
|
|
|
|
|
|
|
213,769 |
|
Corporate bonds |
|
|
|
|
|
|
116,626 |
|
|
|
|
|
|
|
116,626 |
|
Residential agency mortgage-backed securities |
|
|
|
|
|
|
14,753 |
|
|
|
|
|
|
|
14,753 |
|
Collateralized mortgage obligations |
|
|
|
|
|
|
255,336 |
|
|
|
|
|
|
|
255,336 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Total fixed maturities |
|
|
55,966 |
|
|
|
967,503 |
|
|
|
|
|
|
|
1,023,469 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Equity securities |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Common stocks |
|
|
3,686 |
|
|
|
|
|
|
|
|
|
|
|
3,686 |
|
Preferred stocks |
|
|
3,845 |
|
|
|
|
|
|
|
|
|
|
|
3,845 |
|
Perpetual preferred stocks |
|
|
921 |
|
|
|
|
|
|
|
|
|
|
|
921 |
|
Mutual funds |
|
|
24,211 |
|
|
|
39,732 |
|
|
|
846 |
|
|
|
64,789 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Total equity securities |
|
|
32,663 |
|
|
|
39,732 |
|
|
|
846 |
|
|
|
73,241 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Derivatives (reported within other assets in
the consolidated balance sheets) |
|
|
|
|
|
|
659 |
|
|
|
|
|
|
|
659 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Total |
|
$ |
134,857 |
|
|
$ |
1,007,894 |
|
|
$ |
846 |
|
|
$ |
1,143,597 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
22
Triple-S Management Corporation
Notes to Consolidated Financial Statements
(Dollar amounts in thousands, except per share data)
(Unaudited)
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
December 31, 2009 |
|
|
|
Level 1 |
|
|
Level 2 |
|
|
Level 3 |
|
|
Total |
|
Equity securities held for trading |
|
$ |
43,909 |
|
|
$ |
|
|
|
$ |
|
|
|
$ |
43,909 |
|
Securities available for sale: |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Fixed maturity securities |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Obligations of government-sponsored |
|
|
|
|
|
|
251,428 |
|
|
|
|
|
|
|
251,428 |
|
U.S. Treasury securities and obligations of U.S
government instrumentalities |
|
|
51,338 |
|
|
|
|
|
|
|
|
|
|
|
51,338 |
|
Obligations of the Commonwealth of Puerto
and its instrumentalities |
|
|
|
|
|
|
155,948 |
|
|
|
|
|
|
|
155,948 |
|
Municipal securities |
|
|
|
|
|
|
106,707 |
|
|
|
|
|
|
|
106,707 |
|
Corporate bonds |
|
|
|
|
|
|
105,365 |
|
|
|
|
|
|
|
105,365 |
|
Residential agency mortgage-backed securities |
|
|
|
|
|
|
17,281 |
|
|
|
|
|
|
|
17,281 |
|
Collateralized mortgage obligations |
|
|
|
|
|
|
230,910 |
|
|
|
|
|
|
|
230,910 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Total fixed maturities |
|
|
51,338 |
|
|
|
867,639 |
|
|
|
|
|
|
|
918,977 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Equity securities |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Common stocks |
|
|
7,509 |
|
|
|
|
|
|
|
|
|
|
|
7,509 |
|
Preferred stocks |
|
|
2,675 |
|
|
|
|
|
|
|
|
|
|
|
2,675 |
|
Perpetual preferred stocks |
|
|
2,579 |
|
|
|
|
|
|
|
|
|
|
|
2,579 |
|
Mutual funds |
|
|
6,961 |
|
|
|
44,190 |
|
|
|
775 |
|
|
|
51,926 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Total equity securities |
|
|
19,724 |
|
|
|
44,190 |
|
|
|
775 |
|
|
|
64,689 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Derivatives (reported within other assets in
the consolidated balance sheets) |
|
|
|
|
|
|
1,608 |
|
|
|
|
|
|
|
1,608 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Total |
|
$ |
114,971 |
|
|
$ |
913,437 |
|
|
$ |
775 |
|
|
$ |
1,029,183 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
The fair value of fixed maturity and equity securities included in the Level 2 category
were based on market values obtained from independent pricing services, which utilizes evaluated
pricing models that vary by asset class and incorporate available trade, bid and other market
information and for structured securities, cash flow and when available loan performance data.
Because many fixed income securities do not trade on a daily basis, the pricing companys evaluated
pricing applications apply available information as applicable through processes such as benchmark
curves, benchmarking of like securities, sector groupings, and matrix pricing, to prepare
evaluations. For certain equity securities, quoted market prices for the identical security are
not always available and the fair value is estimated by reference to similar securities for which
quoted prices are available. The independent pricing services monitor market indicators, industry
and economic events, and for broker-quoted only securities, obtain quotes from market makers or
broker-dealers that they recognize to be market participants.
23
Triple-S Management Corporation
Notes to Consolidated Financial Statements
(Dollar amounts in thousands, except per share data)
(Unaudited)
A reconciliation of the beginning and ending balances of assets measured at fair value on a
recurring basis using significant unobservable inputs (Level 3) for the three months and nine
months ended September 30, 2010 and 2009 is as follows:
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Three months ended |
|
|
|
September 30, 2010 |
|
|
September 30, 2009 |
|
|
|
|
Fixed |
|
|
|
|
|
|
|
|
|
|
Fixed |
|
|
|
|
|
|
|
|
|
Maturity |
|
|
Equity |
|
|
|
|
|
|
Maturity |
|
|
Equity |
|
|
|
|
|
|
Securities |
|
|
Securities |
|
|
Total |
|
|
Securities |
|
|
Securities |
|
|
Total |
|
Beginning balance |
|
$ |
|
|
|
$ |
699 |
|
|
$ |
699 |
|
|
$ |
560 |
|
|
$ |
1,747 |
|
|
$ |
2,307 |
|
Total gains or losses: |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Realized in earnings |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
(240 |
) |
|
|
|
|
|
|
(240 |
) |
Unrealized in other accumulated
comprehensive income |
|
|
|
|
|
|
(6 |
) |
|
|
(6 |
) |
|
|
|
|
|
|
|
|
|
|
|
|
Purchases and sales |
|
|
|
|
|
|
153 |
|
|
|
153 |
|
|
|
|
|
|
|
|
|
|
|
|
|
Transfers in and/or out of Level 3 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Ending balance |
|
$ |
|
|
|
$ |
846 |
|
|
$ |
846 |
|
|
$ |
320 |
|
|
$ |
1,747 |
|
|
$ |
2,067 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Nine months ended |
|
|
|
September 30, 2010 |
|
|
September 30, 2009 |
|
|
|
|
Fixed |
|
|
|
|
|
|
|
|
|
|
Fixed |
|
|
|
|
|
|
|
|
|
Maturity |
|
|
Equity |
|
|
|
|
|
|
Maturity |
|
|
Equity |
|
|
|
|
|
|
Securities |
|
|
Securities |
|
|
Total |
|
|
Securities |
|
|
Securities |
|
|
Total |
|
Beginning balance |
|
$ |
|
|
|
$ |
775 |
|
|
$ |
775 |
|
|
$ |
1,281 |
|
|
$ |
1,086 |
|
|
$ |
2,367 |
|
Total gains or losses: |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Realized in earnings |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
(1,264 |
) |
|
|
|
|
|
|
(1,264 |
) |
Unrealized in other accumulated
comprehensive income |
|
|
|
|
|
|
(253 |
) |
|
|
(253 |
) |
|
|
303 |
|
|
|
661 |
|
|
|
964 |
|
Purchases and sales |
|
|
|
|
|
|
324 |
|
|
|
324 |
|
|
|
|
|
|
|
|
|
|
|
|
|
Transfers in and/or out of Level 3 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Ending balance |
|
$ |
|
|
|
$ |
846 |
|
|
$ |
846 |
|
|
$ |
320 |
|
|
$ |
1,747 |
|
|
$ |
2,067 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
There were no transfers in or transfers out of Level 3 for the nine months ended
September 30, 2010 and 2009.
As of September 30, 2010, a mutual fund investment was classified as Level 3 due to the
unavailability of market quotes for the underlying securities.
During the three months and nine months ended September 30, 2009, certain fixed maturity and
equity securities classified at Level 3 were thinly traded due to issuer liquidity concerns.
Consequently, broker quotes or other observable inputs were not always available and the fair value
of these securities was estimated using internal estimates for inputs including, but not limited
to, credit spreads, default rates and benchmark yields. An other-than-
temporary impairment of approximately $0.2 million and $1.3 million was recorded on Level 3
securities during the three months and nine months ended September 30, 2009.
(9) Share-Based Compensation
Share-based compensation expense recorded during the three months and nine months ended
September 30, 2010 was $638 and $1,316, respectively. Share-based compensation expense recorded
during the three months and nine months ended September 30, 2009 was $779 and $3,258, respectively.
Share based compensation expense for the nine months ended September 30, 2009 includes $937 of
compensation cost that should have been recorded in
24
Triple-S Management Corporation
Notes to Consolidated Financial Statements
(Dollar amounts in thousands, except per share data)
(Unaudited)
earlier periods. This adjustment relates to employees that qualified for approved retirement as
defined under the plan.
Pursuant to the 2007 Incentive Plan, on September 30, 2010 the Corporation granted certain key
employees 4,032 stock options, 741 shares of restricted stocks, and 741 performance
awards. Effective July 12, 2010, the Corporation granted 15,480 shares of restricted stock to
non-employee directors pursuant to the 2007 Incentive Plan.
(10) Comprehensive Income (Loss)
The accumulated balances for each classification of other comprehensive income (loss), net of
tax, are as follows:
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Accumulated |
|
|
|
Net unrealized |
|
|
Liability for |
|
|
other |
|
|
|
gain on |
|
|
pension |
|
|
comprehensive |
|
|
|
securities |
|
|
benefits |
|
|
income (loss) |
|
Balance at January 1 |
|
$ |
9,141 |
|
|
$ |
(20,717 |
) |
|
$ |
(11,576 |
) |
Net current period change |
|
|
48,332 |
|
|
|
886 |
|
|
|
49,218 |
|
|
|
|
|
|
|
|
|
|
|
Balance at September 30 |
|
$ |
57,473 |
|
|
$ |
(19,831 |
) |
|
$ |
37,642 |
|
|
|
|
|
|
|
|
|
|
|
(11) Income Taxes
Under Puerto Rico income tax law, the Corporation is not allowed to file consolidated tax
returns with its subsidiaries. The Corporation and its subsidiaries are subject to Puerto Rico
income taxes. The Corporations insurance subsidiaries are also subject to U.S. federal income
taxes for foreign source dividend income. As of September 30, 2010, tax years 2004 through 2009
for the Corporation and its subsidiaries are subject to examination by Puerto Rico taxing
authorities.
Income taxes are accounted for under the asset and liability method. Deferred tax assets and
liabilities are recognized for future tax consequences attributable to differences between the
financial statements carrying amounts of existing assets and liabilities and their respective tax
bases and operating loss and tax credit carry-forwards. Deferred tax assets and liabilities are
measured using enacted tax rates expected to apply to taxable income in the years in which those
temporary differences are expected to be recovered or settled. The effect on deferred tax assets
and liabilities of a change in tax rates is recognized in the consolidated statements of earnings
in the period that includes the enactment date. Quarterly income taxes are calculated using the
effective tax rate determined based on the income forecasted for the full fiscal year.
On July 10, 2009 the Governor of Puerto Rico signed into law Puerto Ricos Act No. 37, which
requires certain corporations to pay a 5% additional special tax over tax liability. The effective
tax rate includes the additional special tax, as enacted.
25
Triple-S Management Corporation
Notes to Consolidated Financial Statements
(Dollar amounts in thousands, except per share data)
(Unaudited)
(12) Pension Plan
The components of net periodic benefit cost for the three months and nine months ended
September 30, 2010 and 2009 were as follows:
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Three months ended |
|
|
Nine months ended |
|
|
|
September 30, |
|
|
September 30, |
|
|
|
2010 |
|
|
2009 |
|
|
2010 |
|
|
2009 |
|
Components of net periodic benefit cost: |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Service cost |
|
$ |
1,218 |
|
|
$ |
1,372 |
|
|
$ |
3,772 |
|
|
$ |
3,791 |
|
Interest cost |
|
|
1,478 |
|
|
|
1,614 |
|
|
|
4,497 |
|
|
|
4,290 |
|
Expected return on assets |
|
|
(1,044 |
) |
|
|
(1,135 |
) |
|
|
(3,148 |
) |
|
|
(3,047 |
) |
Amortization of prior service benefit |
|
|
(110 |
) |
|
|
(127 |
) |
|
|
(333 |
) |
|
|
(340 |
) |
Amortization of actuarial loss |
|
|
588 |
|
|
|
718 |
|
|
|
1,782 |
|
|
|
1,809 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Net periodic benefit cost |
|
$ |
2,130 |
|
|
$ |
2,442 |
|
|
$ |
6,570 |
|
|
$ |
6,503 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Employer contributions: The Corporation disclosed in its audited consolidated financial
statements for the year ended December 31, 2009 that it expected to contribute $7,000 to its
pension program in 2010. As of September 30, 2010, the Corporation has contributed $9,800 to the
pension program. The Corporation does not expect to make further contributions to the program
during 2010.
(13) Net Income Available to Stockholders and Net Income per Share
The following table sets forth the computation of basic and diluted earnings per share for the
three months and nine months ended September 30, 2010 and 2009:
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Three months ended |
|
|
Nine months ended |
|
|
|
September 30, |
|
|
September 30, |
|
|
|
2010 |
|
|
2009 |
|
|
2010 |
|
|
2009 |
|
Numerator for earnings per share: |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Net income available to stockholders |
|
$ |
20,488 |
|
|
$ |
18,084 |
|
|
$ |
46,737 |
|
|
$ |
40,676 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Denominator for basic earnings per share: |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Weighted average of common shares |
|
|
29,095,272 |
|
|
|
29,265,472 |
|
|
|
29,085,188 |
|
|
|
29,607,691 |
|
Effect of dilutive securities |
|
|
220,301 |
|
|
|
107,462 |
|
|
|
197,690 |
|
|
|
64,876 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Denominator for diluted earnings per share |
|
|
29,315,573 |
|
|
|
29,372,934 |
|
|
|
29,282,878 |
|
|
|
29,672,567 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Basic net income per share |
|
$ |
0.70 |
|
|
$ |
0.62 |
|
|
$ |
1.61 |
|
|
$ |
1.37 |
|
Diluted net income per share |
|
$ |
0.70 |
|
|
$ |
0.62 |
|
|
$ |
1.60 |
|
|
$ |
1.37 |
|
During the nine months ended September 30, 2009, the weighted average of stock option shares
of approximately 1,013,000 was excluded from the denominator for the diluted earnings per share
computation because the stock options were anti-dilutive. There were no anti-dilutive stock
options during the three months and nine months ended September 30, 2010 and during the three
months ended September 30, 2009.
(14) Contingencies
As of September 30, 2010, the Corporation is a defendant in various lawsuits arising in the
ordinary course of business. We are also defendants in various other claims and proceedings, some
of which are described below. Furthermore, the Commissioner of Insurance, as well as other Federal
and Puerto Rico government authorities,
26
Triple-S Management Corporation
Notes to Consolidated Financial Statements
(Dollar amounts in thousands, except per share data)
(Unaudited)
regularly make inquiries and conduct audits concerning the Corporations compliance with applicable
insurance and other laws and regulations.
Management believes that the aggregate liabilities, if any, arising from all such claims,
assessments, audits and lawsuits will not have a material adverse effect on the consolidated
financial position or results of operations of the Corporation. However, given the inherent
unpredictability of these matters, it is possible that an adverse outcome in certain matters could
have a material adverse effect on the financial condition, operating results and/or cash flows.
Where the Corporation believes that a loss is both probable and estimable, such amounts have been
recorded. In other cases, it is at least reasonably possible that the Corporation may incur a loss
related to one or more of the mentioned pending lawsuits or investigations, but the Corporation is
unable to estimate the range of possible loss which may be ultimately realized, either individually
or in the aggregate, upon their resolution.
Additionally, we may face various potential litigation claims that have not been asserted to
date, including claims from persons purporting to have contractual rights to acquire shares of the
Corporation on favorable terms or to have inherited such shares notwithstanding applicable transfer
and ownership restrictions.
Hau et al Litigation (formerly known as Jordan et al)
On April 24, 2002, Octavio Jordán, Agripino Lugo, Ramón Vidal, and others filed a suit against
the Corporation, the Corporations subsidiary TSS and others in the Court of First Instance for San
Juan, Superior Section (the Court of First Instance), alleging, among other things, violations by
the defendants of provisions of the Puerto Rico Insurance Code, antitrust violations, unfair
business practices, RICO violations, breach of contract with providers, and damages in the amount
of $12 million. Following years of complaint amendments, motions practice and interim appeals up to
the level of the Puerto Rico Supreme Court, the plaintiffs amended their complaint on June 20, 2008
to allege with particularity the same claims initially asserted but on behalf of a more limited
group of plaintiffs, and increase their claim for damages to approximately $207 million. Discovery
is ongoing. The Corporation intends to vigorously defend this claim.
Dentists Association Litigation
On February 11, 2009, the Puerto Rico Dentists Association (Colegio de Cirujanos Dentistas de
Puerto Rico) filed a complaint in the Court of First Instance against 24 health plans operating in
Puerto Rico that offer dental health coverage. The Corporation and two of its subsidiaries, TSS and
Triple-C, Inc. (TCI), were included as defendants. This litigation purports to be a class action
filed on behalf of Puerto Rico dentists who are similarly situated; however, the complaint does not
include a single dentist as a class representative nor a definition of the intended class.
The complaint alleges that the defendants, on their own and as part of a common scheme,
systematically deny, delay and diminish the payments due to dentists so that they are not paid in a
timely and complete manner for the covered medically necessary services they render. The complaint
also alleges, among other things, violations to the Puerto Rico Insurance Code, antitrust laws, the
Puerto Rico racketeering statute, unfair business practices, breach of contract with providers, and
damages in the amount of $150 million. In addition, the complaint claims that the Puerto Rico
Insurance Companies Association is the hub of an alleged conspiracy concocted by the member plans
to
defraud dentists. There are numerous available defenses to oppose both the request for class
certification and the merits. The Corporation intends to vigorously defend this claim.
Two codefendant plans removed the case to federal court, which the plaintiffs and the other
codefendants, including the Corporation, opposed. The federal District Court decided that it lacked
jurisdiction under the Class Action Fairness Act (CAFA) and remanded the case to state court. The
removing defendants petitioned to appeal to the First Circuit Court of Appeals. Having accepted the
appeal, the First Circuit Court of Appeals issued an order in late October 2009 which found the
lower courts decision premature. The Court of Appeals remanded the case to the federal District
Court and allowed limited discovery to determine whether the case should be heard in federal court
pursuant to CAFA. The parties completed the limited discovery in August 2010 and supplemented
their previous filings.
27
Triple-S Management Corporation
Notes to Consolidated Financial Statements
(Dollar amounts in thousands, except per share data)
(Unaudited)
Colón Litigation
On October 15, 2007, José L. Colón-Dueño, a former holder of one share of TSS predecessor
stock, filed suit against TSS and the Puerto Rico Commissioner of Insurance (the Commissioner) in
the Court of First Instance. The sale of that share to Mr. Colón-Dueño was voided in 1999 pursuant
to an order issued by the Commissioner in which the sale of 1,582 shares to a number of TSS
shareholders was voided. TSS, however, appealed the Commissioners order before the Puerto Rico
Court of Appeals, which upheld the order on March 31, 2000. Plaintiff requests that the court
direct TSS to return his share of stock and compensate him for alleged damages in excess of
$500,000 plus attorneys fees. The Corporation is vigorously contesting this lawsuit because, among
other reasons, the Commissioners order is final and cannot be collaterally attacked in this
litigation.
Puerto Rico Center for Municipal Revenue Collection
On March 1, 2006 and March 3, 2006, respectively, the Puerto Rico Center for Municipal Revenue
Collection (CRIM) imposed a real property tax assessment of approximately $1.3 million and a
personal property tax assessment of approximately $4.0 million upon TSS for fiscal years 1992-1993
through 2002-2003. During that time, TSS qualified as a tax-exempt entity under Puerto Rico law
pursuant to rulings issued by the Puerto Rico tax authorities. In imposing the tax assessments,
CRIM revoked the tax rulings retroactively, based on its contention that a for-profit corporation
such as TSS is not entitled to such an exemption. TSS unsuccessfully filed suit in the local court
system up to the level of the Puerto Rico Supreme Court and a petition for a writ of certiorari
before the U.S. Supreme Court, based on its strong belief that CRIMs retroactive revocation of
applicable tax rulings and its imposition of a tax liability reaching back over ten years
constituted a violation of the Corporations due process rights.
TSS has decided to benefit from an incentive plan established under Law No. 71 of July 2,
2010, which waives accumulated interest, penalties and surcharges. As a result TSS will pay a
total of approximately $5.3 million in property taxes for the period involved in this litigation.
The amount accrued is included within accounts payable and accrued liabilities in the accompanying
consolidated financial statements.
Claims by Heirs of Former Shareholders
The Corporation and TSS are defending five individual lawsuits, all filed in state court, from
persons who claim to have inherited a total of 80 shares of the Corporation or one of its
predecessors or affiliates (before giving effect to the 3,000-for-one stock split). While each case
presents unique facts, the lawsuits generally allege that the redemption of the shares by the
Corporation pursuant to transfer and ownership restrictions contained in the Corporations (or its
predecessors or affiliates) articles of incorporation and bylaws was improper. One of the cases
is in its initial stage; in the other cases, discovery has been completed and the parties are
awaiting trial. Management believes all these claims are time barred under one or more statutes of
limitations and other grounds and is vigorously defending them.
ACODESE Investigation
During April 2010, each of the Companys wholly-owned insurance subsidiaries received
subpoenas for documents from the U.S. Attorney for the Commonwealth of Puerto Rico (the U.S.
Attorney) and the Puerto Rico
Department of Justice (PRDOJ) requesting information principally related to the Asociación
de Compañías de Seguros de Puerto Rico, Inc. (ACODESE by its Spanish acronym). Also in April, the
Companys insurance subsidiaries received a request for information from the Office of the
Commissioner of Insurance of Puerto Rico (OCI) related principally to ACODESE. The Companys
insurance subsidiaries are members of ACODESE, an insurance trade association established in Puerto
Rico since 1975, and their current presidents have participated over the years on ACODESEs board
of directors.
The Company believes similar subpoenas and information requests were issued to other member
companies of ACODESE in connection with the investigation of alleged payments by the former
Executive Vice President of
28
Triple-S Management Corporation
Notes to Consolidated Financial Statements
(Dollar amounts in thousands, except per share data)
(Unaudited)
ACODESE to members of the Puerto Rico Legislative Assembly beginning in 2005. The Company, however,
has not been informed of the specific subject matter of the investigations being conducted by the
U.S. Attorney, the PRDOJ or the OCI. The Company is fully complying with the subpoenas and the
request for information and intends to cooperate with any related government investigation. The
Company at this time cannot reasonably assess the outcome of these investigations or their impact
on the Company.
Intrusions into Triple-C, Inc. Internet IPA Database
On September 21, 2010, we learned from a competitor that a specific internet database managed
by our subsidiary TCI, containing information pertaining to individuals previously insured by TSS
under the Government of Puerto Ricos Health Insurance Plan (HIP) and to independent practice
associations (IPAs) that provided services to those individuals, had been accessed without
authorization by certain of our competitors employees from September 9 to September 15, 2010. We
immediately began an investigation and engaged external resources to assist in this matter. TCI
served as a third-party administrator for TSS in the administration of its HIP contracts until
September 30, 2010. We have identified the information that was accessed and downloaded into the
competitors system. The September 2010 intrusions may have potentially compromised protected
health information of approximately 398,000 beneficiaries in the North and Metro-North regions of
the HIP. We have also learned as a result of our ongoing investigation that protected health
information of approximately 5,500 HIP beneficiaries, 2,500 Medicare beneficiaries and IPA data
from all three HIP regions previously serviced by TSS was accessed through multiple, separate
intrusions into the TCI IPA database from October 2008 to August 2010. The stolen information did
not include Social Security numbers.
Our investigation has revealed that the security breaches were the result of unauthorized use
of one or more active user IDs and passwords specific to the TCI IPA database, and not the result
of breaches of TSSs or the Corporations system security features. We cannot at this time
determine the purpose of these breaches and do not know the extent of any fraudulent use of the
information or its impact on the potentially affected individuals and IPAs. We believe, however,
that the most likely target was financial information related to IPAs rather than the individuals
information. During the course of our investigation we learned that there may have been improper
uses of the IPA passwords by one or more consultants working for the IPAs. We have taken measures
to strengthen the TCI server security and credentials management procedures, and are conducting an
assessment of our system-wide data and facility security to prevent the occurrence of a similar
incident in the future. We continue to investigate these events and to analyze the data as it
becomes known to us to identify all individuals and entities whose information may have been
impacted, and to take any additional corresponding remedial actions in accordance with applicable
laws and regulations.
We have notified the appropriate Puerto Rico and federal government agencies of these events,
and have issued public notice of the breaches as required under Puerto Rico law. We have received
a number of inquiries and requests for information related to these events from these government
agencies and are cooperating with them. As a result of our ongoing investigation, we have
determined that additional filings and public notices will be required. In addition, the Puerto
Rico government agency that oversees the HIP has levied a fine of $100,000 on TSS in connection
with these incidents, which we are appealing. Other government agencies may seek to impose fines
or other obligations on us. We do not have sufficient information at this time to predict whether
any future action by government entities or others as a result of the data breaches would adversely
affect our business, financial condition and results of operations.
(15) Subsequent Event
The Corporation evaluated subsequent events through the date that these consolidated interim
financial statements were issued. No events have occurred that required disclosure or adjustments.
29
|
|
|
Item 2. Managements Discussion and Analysis of Financial Condition and Results of Operations |
The Managements Discussion and Analysis of Financial Condition and Results of Operations
included in this Quarterly Report on Form 10-Q is intended to update the reader on matters
affecting the financial condition and results of operations for the three months and nine months
ended September 30, 2010. Therefore, the following discussion should be read in conjunction with
the audited consolidated financial statements and notes thereto included in the Annual Report on
Form 10-K filed with the United States Securities and Exchange Commission as of and for the year
ended December 31, 2009.
Cautionary Statement Regarding Forward-Looking Information
This Quarterly Report on Form 10-Q and other of our publicly available documents may include
statements that constitute forward-looking statements within the meaning of the Private
Securities Litigation Reform Act of 1995, including, among other things: statements concerning our
business and our financial condition and results of operations. These statements are not
historical, but instead represent our belief regarding future events, any of which, by their
nature, are inherently uncertain and outside of our control. These statements may address, among
other things, future financial results, strategy for growth, and market position. It is possible
that our actual results and financial condition may differ, possibly materially, from the
anticipated results and financial condition indicated in these forward-looking statements. The
factors that could cause actual results to differ from those in the forward-looking statements are
discussed throughout this form. We are not under any obligation to update or alter any
forward-looking statement (and expressly disclaims any such obligations), whether as a result of
new information, future events or otherwise. Factors that may cause actual results to differ
materially from those contemplated by such forward looking statements include, but are not limited
to, rising healthcare costs, business conditions and competition in the different insurance
segments, government action and other regulatory issues.
Overview
We are one of the most significant players in the managed care industry in Puerto Rico and
have over 50 years of experience in this industry. We offer a broad portfolio of managed care and
related products in the Commercial and Medicare (including Medicare Advantage and the Part D
stand-alone prescription drug plan (PDP)) markets. In the Commercial market we are the largest
provider of managed care products. We offer products to corporate accounts, U.S. federal
government employees, local government employees, individual accounts and Medicare Supplement. We
also participated in the Government of Puerto Rico Health Reform (Medicaid) up to September 30,
2010. Medicaid is a government of Puerto Rico-funded managed care program for the medically
indigent that is similar to the Medicaid program in the U.S.
We have the exclusive right to use the Blue Cross Blue Shield name and mark throughout Puerto
Rico and U.S. Virgin Islands. As of September 30, 2010 we serve approximately 1.3 million members
across all regions of Puerto Rico and U.S. Virgin Islands. Excluding the Medicaid membership,
which we served until September 30, 2010, we serve over 800 thousand members covering approximately
20% of the Puerto Rico population. For the nine months ended September 30, 2010, our managed care
segment represented approximately 90% of our total consolidated premiums earned. We also have
significant positions in the life insurance and property and casualty insurance markets. Our life
insurance segment had a market share of approximately 12.5% (in terms of direct premiums) during
the year ended December 31, 2009. Our property and casualty segment had a market share of
approximately 9% (in terms of direct premiums) during the year ended December 31, 2009.
We participate in the managed care market through our subsidiary, Triple-S Salud, Inc.
(TSS). Our managed care subsidiary is a Blue Cross Blue Shield Association (BCBSA) licensee,
which provides us with exclusive use of the Blue Cross Blue Shield name and mark throughout Puerto
Rico and U.S. Virgin Islands.
We participate in the life insurance market through our subsidiary, Triple-S Vida, Inc.
(TSV) and in the property and casualty insurance market through our subsidiary, Triple-S
Propiedad, Inc. (TSP), each one representing approximately 5% of our consolidated premiums
earned, net for the nine months ended September 30, 2010.
Intersegment revenues and expenses are reported on a gross basis in each of the operating
segments but eliminated in the consolidated results. Except as otherwise indicated, the numbers
for each segment presented in
30
this Quarterly Report on Form 10-Q do not reflect intersegment eliminations. These
intersegment revenues and expenses affect the amounts reported on the financial statement line
items for each segment, but are eliminated in consolidation and do not change net income. The
following table shows premiums earned, net and net fee revenue and operating income for each
segment, as well as the intersegment premiums earned, service revenues and other intersegment
transactions, which are eliminated in the consolidated results:
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Three months ended |
|
|
Nine months ended |
|
|
|
September 30, |
|
|
September 30, |
|
(Dollar amounts in millions) |
|
2010 |
|
|
2009 |
|
|
2010 |
|
|
2009 |
|
Premiums earned, net: |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Managed care |
|
$ |
446.4 |
|
|
$ |
428.2 |
|
|
$ |
1,342.7 |
|
|
$ |
1,246.6 |
|
Life insurance |
|
|
26.7 |
|
|
|
24.7 |
|
|
|
78.7 |
|
|
|
74.5 |
|
Property and casualty insurance |
|
|
24.5 |
|
|
|
24.4 |
|
|
|
75.2 |
|
|
|
73.0 |
|
Intersegment premiums earned |
|
|
(1.1 |
) |
|
|
(1.0 |
) |
|
|
(3.2 |
) |
|
|
(3.4 |
) |
|
|
|
|
|
|
|
|
|
|
|
|
|
Consolidated premiums earned, net |
|
$ |
496.5 |
|
|
$ |
476.3 |
|
|
$ |
1,493.4 |
|
|
$ |
1,390.7 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Administrative service fees: |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Managed care |
|
$ |
10.9 |
|
|
$ |
10.5 |
|
|
$ |
37.1 |
|
|
$ |
32.0 |
|
Intersegment administrative service fees |
|
|
(0.7 |
) |
|
|
(0.7 |
) |
|
|
(2.2 |
) |
|
|
(2.0 |
) |
|
|
|
|
|
|
|
|
|
|
|
|
|
Consolidated administrative service fees |
|
$ |
10.2 |
|
|
$ |
9.8 |
|
|
$ |
34.9 |
|
|
$ |
30.0 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Operating income: |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Managed care |
|
$ |
16.4 |
|
|
$ |
10.1 |
|
|
$ |
47.5 |
|
|
$ |
32.1 |
|
Life insurance |
|
|
4.6 |
|
|
|
4.0 |
|
|
|
13.1 |
|
|
|
10.9 |
|
Property and casualty insurance |
|
|
2.2 |
|
|
|
0.2 |
|
|
|
3.3 |
|
|
|
4.4 |
|
Intersegment and other |
|
|
0.7 |
|
|
|
1.1 |
|
|
|
2.4 |
|
|
|
3.0 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Consolidated operating income |
|
$ |
23.9 |
|
|
$ |
15.4 |
|
|
$ |
66.3 |
|
|
$ |
50.4 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Our revenues primarily consist of premiums earned, net and administrative service fees. These
revenues are derived from the sale of managed care products in the Commercial market to employer
groups, individuals and government-sponsored programs, principally Medicare and Medicaid. Premiums
are derived from insurance contracts and administrative service fees are derived from self-funded
contracts, under which we provide a range of services, including claims administration, billing and
membership services, among others. Revenues also include premiums earned from the sale of property
and casualty and life insurance contracts, and investment income. Substantially all of our
earnings are generated in Puerto Rico.
Claims incurred include the payment of benefits and losses, mostly to physicians, hospitals
and other service providers, and to policyholders. Each segments results of operations depend in
significant part on their ability to accurately predict and effectively manage claims. A portion
of the claims incurred for each period consists of claims reported but not paid during the period,
as well as a management and actuarial estimate of claims incurred but not reported during the
period. Operating expenses consist primarily of compensation expenses, commission payments to
brokers and other overhead business expenses.
We use operating income as a measure of performance of the underwriting and investment
functions of our segments. We also use the loss ratio and the operating expense ratio as measures
of performance. The loss ratio is claims incurred divided by premiums earned, net, multiplied by
100. The operating expense ratio is operating expenses divided by premiums earned; net and
administrative service fees, multiplied by 100.
Recent Developments
Federal Health Reform Legislation
On March 23, 2010, President Obama signed into law federal health reform legislation, known as
the Patient Protection and Affordable Care Act. As further detailed below, the Patient Protection
and Affordable Care Act, as amended by the Health Care and Education Reconciliation Act of 2010,
which was signed into law on March 30, 2010 (collectively, Pub. L. No. 111-148, and referred to
herein as PPACA), includes certain mandates that will take effect in 2010, as well as other
requirements that will take effect over the next eight (8) years. Many aspects of the PPACA will
be further articulated and clarified through regulation and guidance. The PPACA effects all
aspects
31
of the health care delivery and reimbursement system in the United States, including health
insurers, managed care organizations, health care providers, employers, and U.S. states and
territories.
The implementation of PPACA could have a material adverse effect on the profitability or
marketability of our business, financial condition and results of operations. Because of the
absence of the anticipated regulations and guidance, we are not able to fully assess the impact of
the PPACA on us at this time and we will continue to assess its impact on us as these regulations
and guidance are issued.
Some of the more significant PPACA issues that may affect our managed care business (including
our Commercial, Medicare and Medicaid sectors) include:
|
|
Provisions requiring greater access to coverage for certain uninsured and under-insured populations and the elimination of
certain underwriting practices without adequate funding to health plans or other negative financial levy on health plans
such as restrictions in ability to charge additional premium for additional risk, including but not limited to provisions:
(i) extending dependent coverage for unmarried individuals until age 26 under their parents health coverage, (ii)
limiting a health plans ability to rescind coverage and restrict the plans ability to establish annual and lifetime
financial caps, and (iii) limiting a health plans ability to deny or limit coverage on grounds of a persons pre-existing
medical condition; |
|
|
|
Provisions restricting medical loss ratios and imposing significant penalties for non-compliance; |
|
|
|
Provisions requiring health plans to report to their members and the United States Department of Health and Human Services
(HHS) certain quality performance measures and their wellness promotion activities; |
|
|
|
Provisions that freeze premium payments to Medicare Advantage health plans beginning in 2011 and that tie such premium to
the local Medicare fee for service costs. The adjustment will be phased in over between 3 and 7 years depending on the
amount of the eventual adjustment; |
|
|
|
Provisions that tie Medicare Advantage premiums to achievement of certain quality performance measures; |
|
|
|
Other efforts or specific legislative changes to the Medicare and Medicaid programs, including changes in the bidding
process, authority of the Centers for Medicare and Medicaid Services (CMS) to deny bids, or other means of materially
reducing premiums such as through further adjustments to the risk adjustment methodology; |
|
|
|
Increased federal funding to the Reform program available for years 2014 2019; |
|
|
|
Funding provided to the Commonwealth of Puerto Rico to either establish health insurance exchanges or fund the Puerto Rico
Medicaid program at the discretion of the Governor; |
|
|
|
Increased government funding to enforcement agencies and/or changes in interpretation or application of fraud and abuse
laws; |
|
|
|
Expanded scope of authority and/or funding to audit Medicare Advantage health plans and recoup premiums or other funds by
the government or its representatives; and |
|
|
|
The increase in persons eligible for coverage under the Medicaid program in Puerto Rico may result in some persons
currently insured by us in our Commercial programs becoming eligible for, and thus moving to, the Medicaid program. |
The constitutionality of the PPACA is being challenged by a number of states in the U.S.
District Courts in Florida and Virginia. We will continue to assess the impact of these state
challenges on the PPACA as they develop.
For a further description of our Business and other Risk Factors, see Items 1 and 1A of Part I
of our Annual Report on Form 10-K for the year ended December 31, 2009. The information included
in this section supplements those materials as to: Item 1. Business sections Regulation, Federal
Regulation, and Legislative and Regulatory Initiatives; and Item 1A. Risk Factors section Risks
Relating to the Regulation of Our Industry Changes in governmental regulations, or the
application thereof, may adversely affect our business, financial condition and results of
operations.
32
Commonwealth of Puerto Rico Healthcare Reform Contracts (Medicaid)
On August 31, 2010, the Puerto Rico Health Insurance Administration notified our managed care
subsidiary, TSS, that the proposal submitted by TSS to provide services to the Medicaid population
was not selected. The current contracts expired by their own terms on September 30, 2010. Total
Medicaid enrollment as of September 30, 2010 was 544,448 members. The Medicaid premiums earned,
net during the nine months ended September 30, 2010 and 2009 amounted to $273.1 million and $257.7
million, respectively. The operating income for the Medicaid business during the nine months ended
September 30, 2010 and 2009 amounted to $5.0 million and $13.7 million, respectively.
Recent Accounting Standards
For a description of recent accounting standards, see note 2 to the unaudited consolidated
financial statements included in this Quarterly Report on Form 10-Q.
Managed Care Membership
|
|
|
|
|
|
|
|
|
|
|
As of September 30, |
|
|
|
2010 |
|
|
2009 |
|
Managed care enrollment: |
|
|
|
|
|
|
|
|
Commercial 1 |
|
|
737,697 |
|
|
|
745,933 |
|
Medicaid 2 |
|
|
544,448 |
|
|
|
537,414 |
|
Medicare 3 |
|
|
64,190 |
|
|
|
69,290 |
|
|
|
|
|
|
|
|
Total |
|
|
1,346,335 |
|
|
|
1,352,637 |
|
|
|
|
|
|
|
|
|
Managed care enrollment by funding arrangement: |
|
|
|
|
|
|
|
|
Fully-insured |
|
|
900,498 |
|
|
|
890,987 |
|
Self-insured |
|
|
445,837 |
|
|
|
461,650 |
|
|
|
|
|
|
|
|
Total |
|
|
1,346,335 |
|
|
|
1,352,637 |
|
|
|
|
|
|
|
|
|
|
|
(1) |
|
Commercial membership includes corporate accounts, self-funded employers, individual
accounts, Medicare Supplement, U.S. Federal government employees and local government
employees. |
|
(2) |
|
Includes rated and self-funded members. |
|
(3) |
|
Includes Medicare Advantage as well as stand-alone PDP plan membership. |
33
Consolidated Operating Results
The following table sets forth the Corporations consolidated operating results. Further
details of the results of operations of each reportable segment are included in the analysis of
operating results for the respective segments.
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Three months ended |
|
|
Nine months ended |
|
|
|
September 30, |
|
|
September 30, |
|
(Dollar amounts in millions) |
|
2010 |
|
|
2009 |
|
|
2010 |
|
|
2009 |
|
Revenues: |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Premiums earned, net |
|
$ |
496.5 |
|
|
|
476.3 |
|
|
$ |
1,493.4 |
|
|
|
1,390.7 |
|
Administrative service fees |
|
|
10.2 |
|
|
|
9.8 |
|
|
|
34.9 |
|
|
|
30.0 |
|
Net investment income |
|
|
12.8 |
|
|
|
12.9 |
|
|
|
37.9 |
|
|
|
38.9 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Total operating revenues |
|
|
519.5 |
|
|
|
499.0 |
|
|
|
1,566.2 |
|
|
|
1,459.6 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Net realized investment gains (losses) |
|
|
(0.3 |
) |
|
|
2.1 |
|
|
|
(0.3 |
) |
|
|
(1.2 |
) |
Net unrealized investment gain on trading securities |
|
|
4.6 |
|
|
|
4.9 |
|
|
|
0.6 |
|
|
|
8.1 |
|
Other income, net |
|
|
0.6 |
|
|
|
0.1 |
|
|
|
0.4 |
|
|
|
0.4 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Total revenues |
|
|
524.4 |
|
|
|
506.1 |
|
|
|
1,566.9 |
|
|
|
1,466.9 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Benefits and expenses: |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Claims incurred |
|
|
421.5 |
|
|
|
412.4 |
|
|
|
1,272.2 |
|
|
|
1,201.1 |
|
Operating expenses |
|
|
74.1 |
|
|
|
71.2 |
|
|
|
227.7 |
|
|
|
208.1 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Total operating expenses |
|
|
495.6 |
|
|
|
483.6 |
|
|
|
1,499.9 |
|
|
|
1,409.2 |
|
Interest expense |
|
|
3.0 |
|
|
|
3.4 |
|
|
|
9.6 |
|
|
|
10.0 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Total benefits and expenses |
|
|
498.6 |
|
|
|
487.0 |
|
|
|
1,509.5 |
|
|
|
1,419.2 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Income before taxes |
|
|
25.8 |
|
|
|
19.1 |
|
|
|
57.4 |
|
|
|
47.7 |
|
Income tax expense |
|
|
5.3 |
|
|
|
1.0 |
|
|
|
10.7 |
|
|
|
7.0 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Net income |
|
$ |
20.5 |
|
|
|
18.1 |
|
|
$ |
46.7 |
|
|
|
40.7 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Three Months Ended September 30, 2010 Compared to Three Months Ended September 30, 2009
Operating Revenues
Consolidated premiums earned, net increased by $20.2 million, or 4.2%, to $496.5 million
during the three months ended September 30, 2010 when compared to the three months ended September
30, 2009. The increase was mostly due to an increase in the premiums earned, net in our Managed
Care segment, primarily from growth in the Commercial membership reflecting organic growth as well
as to higher premium rates, particularly in the Commercial and Medicare businesses.
Claims Incurred
Consolidated claims incurred increased by $9.1 million, or 2.2%, to $421.5 million during the
three months ended September 30, 2010 when compared to the claims incurred during the three months
ended September 30, 2009. This increase is principally due to increased claims in the Managed Care
segment as a result of higher enrollment and an increase in loss adjustment expenses for the
Medicaid business. The consolidated loss ratio decreased by 1.7 percentage points to 84.9%.
Operating Expenses
Consolidated operating expenses during the three months ended September 30, 2010 increased by
$2.9 million, or 4.1%, to $74.1 million as compared to the operating expenses during the three
months ended September 30, 2009. This increase is primarily attributed to a higher volume of
business, particularly in our Managed Care segment, and to expenses related to the implementation
of the new Managed Care information technology (IT) system. For the three months ended September 30, 2010, the
consolidated operating expense ratio remained remained stable at 14.6%.
34
Income Tax Expense
Consolidated income tax expense during the three months ended September 30, 2010 increased by
$4.3 million to $5.3 million as compared to the income tax expense during the three months ended
September 30, 2009. The consolidated effective tax rate increased by 15.3 percentage points, to
20.5%, primarily due to the use of tax credits during the 2009 period.
Nine Months Ended September 30, 2010 Compared to Nine Months Ended September 30, 2009
Operating Revenues
Consolidated premiums earned, net increased by $102.7 million, or 7.4%, to $1,493.4 million
during the nine months ended September 30, 2010 when compared to the nine months ended September
30, 2009. The increase was primarily due to an increase in the premiums earned, net in our Managed
Care segment, primarily from growth in Commercial membership, reflecting, in part, the La Cruz Azul
(LCA) transaction, and organic growth as well as higher premium rates, particularly in the
Commercial and Medicare businesses.
The increase in administrative service fees of $4.9 million, or 16.3%, to $34.9 million in the
2010 period, is attributed to a higher self-insured member months enrollment. Increase is mostly
due to new self-insured members in our Commercial business primarily as the result of the
aforementioned acquisition of LCA, which was effective July 1, 2009.
Consolidated net investment income decreased by $1.0 million, or 2.6%, to $37.9 million during
nine months ended September 30, 2010 mostly as the result of lower yields in fixed income
investment acquired during the period.
Net Realized Investment Losses
Consolidated net realized investment losses of $0.3 million during the 2010 period are the
result of other-than-temporary impairments amounting to $2.9 million related to equity and fixed
income securities, offset in part by net realized gains from the sale of fixed income and equity
securities amounting to $2.6 million.
Net Unrealized Investment Gains on Trading Securities and Other Income, Net
The combined balance of our consolidated net unrealized investment gain on trading securities
and other income, net decreased by $7.5 million, to $1.0 million during the nine months ended
September 30, 2010. This decrease is attributable to a lower increase in fair value of our trading
securities portfolio as compared to last years increase. The unrealized gain experienced on our
trading portfolio represents a combined increase of 3.6% in the market value of the portfolio,
which compares favorably with the changes experienced by the comparable indexes; the Standard and
Poors 500 Index increased by 2.3% and the Russell 1000 Growth decreased by 3.1% during this
period.
Claims Incurred
Consolidated claims incurred increased by $71.1 million, or 5.9%, to $1,272.2 million during
the nine months ended September 30, 2010 when compared to the claims incurred during the nine
months ended September 30, 2009. This increase is principally due to increased claims in the
Managed Care segment as a result of higher enrollment. The consolidated loss ratio decreased by
1.2 percentage points to 85.2%.
Operating Expenses
Consolidated operating expenses during the 2010 period increased by $19.6 million, or 9.4%, to
$227.7 million as compared to the operating expenses during the 2009 period. This increase is
primarily attributed to a higher volume of business, particularly in our Managed Care segment and
expenses related to the implementation of the new Managed Care IT system. The consolidated
operating expense ratio reflects an increase of 0.3 percentage point, to 14.9% during 2010.
Income Tax Expense
Consolidated income tax expense during the nine months ended September 30, 2010 increased
by $3.7 million to $10.7 million as compared to the income tax expense during the nine months ended
September 30, 2009.
35
The consolidated effective tax rate increased by 3.9 percentage points, to 18.6%,
primarily due to the use of tax credits during the 2009 period.
Managed Care Operating Results
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Three months ended |
|
|
Nine months ended |
|
|
|
September 30, |
|
|
September 30, |
|
(Dollar amounts in millions) |
|
2010 |
|
|
2009 |
|
|
2010 |
|
|
2009 |
|
Operating revenues: |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Medical premiums earned, net: |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Commercial |
|
$ |
237.1 |
|
|
$ |
217.3 |
|
|
$ |
715.0 |
|
|
$ |
600.3 |
|
Medicaid |
|
|
92.9 |
|
|
|
89.4 |
|
|
|
273.1 |
|
|
|
257.7 |
|
Medicare |
|
|
116.4 |
|
|
|
121.5 |
|
|
|
354.6 |
|
|
|
388.6 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Medical premiums earned, net |
|
|
446.4 |
|
|
|
428.2 |
|
|
|
1,342.7 |
|
|
|
1,246.6 |
|
Administrative service fees |
|
|
10.9 |
|
|
|
10.5 |
|
|
|
37.1 |
|
|
|
32.0 |
|
Net investment income |
|
|
5.2 |
|
|
|
5.4 |
|
|
|
15.2 |
|
|
|
15.9 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Total operating revenues |
|
|
462.5 |
|
|
|
444.1 |
|
|
|
1,395.0 |
|
|
|
1,294.5 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Medical operating costs: |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Medical claims incurred |
|
|
397.5 |
|
|
|
386.5 |
|
|
|
1,197.6 |
|
|
|
1,126.4 |
|
Medical operating expenses |
|
|
48.6 |
|
|
|
47.5 |
|
|
|
149.9 |
|
|
|
136.0 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Total medical operating costs |
|
|
446.1 |
|
|
|
434.0 |
|
|
|
1,347.5 |
|
|
|
1,262.4 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Medical operating income |
|
$ |
16.4 |
|
|
$ |
10.1 |
|
|
$ |
47.5 |
|
|
$ |
32.1 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Additional data: |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Member months enrollment: |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Commercial: |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Fully-insured |
|
|
1,484,056 |
|
|
|
1,441,028 |
|
|
|
4,521,088 |
|
|
|
3,977,778 |
|
Self-funded |
|
|
735,154 |
|
|
|
812,780 |
|
|
|
2,239,544 |
|
|
|
1,954,997 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Total Commercial member months |
|
|
2,219,210 |
|
|
|
2,253,808 |
|
|
|
6,760,632 |
|
|
|
5,932,775 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Medicaid: |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Fully-insured |
|
|
1,034,749 |
|
|
|
1,011,294 |
|
|
|
3,078,288 |
|
|
|
2,997,800 |
|
Self-funded |
|
|
599,648 |
|
|
|
590,117 |
|
|
|
1,782,426 |
|
|
|
1,723,568 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Total Medicaid member months |
|
|
1,634,397 |
|
|
|
1,601,411 |
|
|
|
4,860,714 |
|
|
|
4,721,368 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Medicare: |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Medicare Advantage |
|
|
165,327 |
|
|
|
179,878 |
|
|
|
506,622 |
|
|
|
565,439 |
|
Stand-alone PDP |
|
|
28,014 |
|
|
|
29,330 |
|
|
|
84,395 |
|
|
|
88,301 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Total Medicare member months |
|
|
193,341 |
|
|
|
209,208 |
|
|
|
591,017 |
|
|
|
653,740 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Total member months |
|
|
4,046,948 |
|
|
|
4,064,427 |
|
|
|
12,212,363 |
|
|
|
11,307,883 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Medical loss ratio |
|
|
89.0 |
% |
|
|
90.3 |
% |
|
|
89.2 |
% |
|
|
90.4 |
% |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Operating expense ratio |
|
|
10.6 |
% |
|
|
10.8 |
% |
|
|
10.9 |
% |
|
|
10.6 |
% |
Three Months Ended September 30, 2010 Compared to Three Months Ended September 30, 2009
Medical Operating Revenues
Medical premiums earned for the three months ended September 30, 2010 increased by $18.2
million, or 4.3%, to $446.4 million when compared to the medical premiums earned during the three
months ended September 30, 2009. This increase is principally the result of the following:
|
|
Medical premiums generated by the Commercial business increased by $19.8 million, or 9.1%, to
$237.1 million during the three months ended September 30, 2010. This fluctuation is
primarily the result of an increase in member months enrollment by 43,028, or 3.0%, and an
increase in average
premium rates in rated group policies of approximately 7.6%. Increase in
member months was primarily attributed to new groups acquired during the
period. |
36
|
|
Medical premiums earned in the Medicaid business
increased by $3.5 million, or 3.9%, to $92.9 million
during the three months ended September 30, 2010.
This fluctuation is due to an increase in member
months enrollment in the fully-insured membership by
23,455, or 2.3%, as well as to an average increase in
premiums rates of 4.8% that was effective September
1st, 2010. |
|
|
|
Medical premiums generated by the Medicare business
decreased during the three months ended September 30,
2010 by $5.1 million, or 4.2%, to $116.4 million.
This fluctuation is the result of an overall decrease
in the member months enrollment of this business by
15,867, or 7.6%, when compared with the same period
in 2009, mostly reflected in our dual-eligible
product. This decrease in member month enrollment is
offset in part by higher average premium rates,
particularly in our dual eligible product, and to
higher CMS risk score adjustment for the 2010 period
as compared to 2009. The three months ended
September 30, 2010 and 2009 include the net effect of
approximately $1.8 million and $0.9 million,
respectively of risk score adjustments corresponding
to prior periods. |
Medical Claims Incurred
Medical claims incurred during the three months ended September 30, 2010 increased by $11.0
million, or 2.8%, to $397.5 million when compared to the three months ended September 30, 2009.
The medical loss ratio (MLR) of the segment decreased 1.3 percentage points during the 2010
period, to 89.0%. These fluctuations are primarily attributed to the effect of the following:
|
|
The medical claims incurred of the Commercial business increased by
$12.0 million, or 6.2%, during the 2010 period and its MLR decreased
by 2.3 percentage points. The increase in claims relates primarily to
the increase in member months enrollment experienced during the 2010
period. The lower MLR is primarily due to the effect of prior period
reserve developments in the 2010 and 2009 periods. Excluding the
effect of prior period reserve developments, the MLR decreased by 1.1
percentage points, mostly resulting from a higher overall trend in
premium rate increases as compared to cost trends as well as to lower
utilization trends in 2010. |
|
|
|
The medical claims incurred of the Medicaid business increased by $4.7
million, or 5.8%, and its MLR increased by 1.7 percentage points
during the three months ended September 30, 2010. The increase in MLR
is primarily due to the effect of prior period reserve developments in
the 2010 and 2009 periods and an increase in loss adjustment expenses.
This increase was offset in part by the 2009 premium adjustment to
provide for unresolved reconciling items with the Government of Puerto
Rico. Excluding the effect of these items in the 2010 and 2009
periods, the MLR increased 5.0 percentage points mostly resulting from
lower premium yields during the 2010 period due to the extension of
the prior years contract with the government without premium rate
increases until September 2010. |
|
|
|
The medical claims incurred of the Medicare business decreased by $5.7
million, or 5.3% during the 2010 period primarily due to a lower
membership and its MLR was 89.3%, 1.1 percentage points lower than the
MLR for same period of the prior year. Excluding the effect of prior
period reserve developments in the 2010 and 2009 period and risk-score
premium adjustments, the MLR increased by 1.0 percentage points
primarily the result of higher utilization trends in our non-dual
product. |
Medical Operating Expenses
Medical operating expenses for the three months ended September 30, 2010 increased by $1.1
million, or 2.3%, to $48.6 million when compared to the three months ended September 30, 2009.
This increase is mainly due to the higher volume of business associated to the increased enrollment
in the 2010 quarter and costs related to the implementation of the new IT system, including
information systems consultants and depreciation and amortization expense, which increased by
approximately $1.7 million and $1.4 million, respectively. These increases were offset in part by
a decrease of approximately $2.1 in contingent property tax accrual during the 2010 period as the
result of the benefit provided by an incentive program established by the government which waives
accumulated interest, penalties and surcharges. The operating expense ratio decreased by 0.2
percentage points, from 10.8% in 2009 to 10.6% in 2010.
37
Nine Months Ended September 30, 2010 Compared to Nine Months Ended September 30, 2009
Medical Operating Revenues
Medical premiums earned for the nine months ended September 30, 2010 increased by $96.1
million, or 7.7%, to $1,342.7 million when compared to the medical premiums earned during the nine
months ended September 30, 2009. This increase is principally the result of the following:
|
|
Medical premiums generated by the Commercial business increased by
$114.7 million, or 19.1%, to $715.0 million during the nine months
ended September 30, 2010. This fluctuation is primarily the result of
an increase in member months enrollment by 543,310, or 13.7%, and an
increase in average premium rates in rated group policies of
approximately 6.1%. Increase in member months was attributed to new
members acquired from LCA effective July 1, 2009, which represent
approximately 35.1% of the increase in member months enrollment
experienced during 2010, and to new groups acquired during the period. |
|
|
|
Medical premiums earned in the Medicaid business increased by $15.4
million, or 6.0%, to $273.1 million during the nine months ended
September 30, 2010. This fluctuation is due to an increase in the
member months enrollment in the fully-insured membership by 80,488, or
2.7%. In addition, the 2009 period includes a premium reduction
adjustment of approximately $8.0 million to provide for unresolved
reconciling items with the Government of Puerto Rico. The average
premiums rates of this business were increased by 4.8% effective
September 1st, 2010. |
|
|
|
Medical premiums generated by the Medicare business decreased by $34.0
million, or 8.7%, to $354.6 million, primarily due to a decrease in
member month enrollment of 62,723, or 9.6%, when compared with the
same period in 2009. The fluctuation in premiums also results from a
lower final risk score adjustments received from CMS in 2010 as
compared to 2009. The nine months ended September 30, 2010 and 2009
include the net effect of approximately $3.0 million and $9.2 million,
respectively, related to CMS risk score adjustments corresponding to
prior periods. These fluctuations were offset in part by higher
average premium rates, particularly in our dual eligible product. |
Administrative service fees increased by $5.1 million, or 15.9%, to $37.1 million during the
2010 period, mainly due to an increase in self-funded member months enrollment of 343,405, or 9.3%.
Increase in members is mainly the result of the contracts acquired from LCA effective July 1,
2009.
Medical Claims Incurred
Medical claims incurred during the nine months ended September 30, 2010 increased by $71.2
million, or 6.3%, to $1,197.6 million when compared to the nine months ended September 30, 2009.
The MLR of the segment decreased 1.2 percentage points during the 2010 period, to 89.2%. These
fluctuations are primarily attributed to the effect of the following:
|
|
The medical claims incurred of the Commercial business increased by
$98.8 million, or 18.1%, during the 2010 period and its MLR decreased
by 0.7 percentage points. The increase in claims relates primarily to
the increase in member months enrollment of 543,310, or 13.7%. The
lower MLR primarily results from a higher overall trend in premium
rate increases as compared to cost trends as well as to lower
utilization trends in 2010. |
|
|
|
The medical claims incurred of the Medicaid business increased by
$25.4 million, or 11.0%, during the 2010 period and its MLR increased
by 4.2 percentage points during the nine months ended September 30,
2010, to 94.1%. The MLR of this business is affected by the 2009
premium adjustment to provide for unresolved reconciling items with
the Government of Puerto Rico and prior period reserve developments.
Considering the effect of these items in the 2009 and 2010 periods,
the MLR increased by 2.8 percentage points during the 2010 period,
mostly resulting from a lower premium yield due to the extension of
the prior years contract with the government without premium rate
increases until September 2010. |
|
|
|
The medical claims incurred of the Medicare business decreased by
$53.0 million, or 15.2%, during the 2010 period primarily due to lower
membership and MLR. The MLR was 83.6%, 6.4 percentage
points lower than the MLR for same period in 2009. The lower MLR mostly results from the
effect of prior period reserve developments in 2010 and 2009 and risk score premium
adjustments. Excluding the effect of prior period reserve developments in the 2010 and 2009
period and risk-score premium adjustments, the MLR decreased by 3.4 percentage points mostly as
the result of higher premium rates and lower utilization in our Medicare products and a new
risk-sharing arrangement with our providers in the dual-eligible product. |
38
Medical Operating Expenses
Medical operating expenses for the nine months ended September 30, 2010 increased by $13.9
million, or 10.2%, to $149.9 million when compared to the nine months ended September 30, 2009.
This increase is mainly due to the higher volume of business associated to the higher enrollment
and costs related to the implementation of the new IT system. The operating expense ratio
increased by 0.3 percentage points, from 10.6% in 2009 to 10.9% in 2010. The higher operating
expense ratio is primarily the result of expenses related to the implementation of the new IT
system, including information systems consultants and depreciation and amortization expense, which,
increased by approximately $1.8 million and $3.1 million, respectively, when compared to the 2009
period expenses; and approximately $1.1 million in expenses related to a new product launched
during January 2010. In addition, the asset purchase amortization related to the LCA acquisition
was approximately $1.0 million higher than during the 2009 period. In the 2009 period a contingent
property tax accrual of approximately $7.5 million was recorded, offset in part by the effect of
$3.6 million related to the settlement of an insurance recovery receivable of legal expenses. This
contingent property tax accrual was decreased by approximately $2.1 million during the 2010 period
as the result of the benefit provided by an incentive program established by the government which
waives accumulated interest, penalties and surcharges.
Life Insurance Operating Results
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Three months ended |
|
|
Nine months ended |
|
|
|
September 30, |
|
|
September 30, |
|
(Dollar amounts in millions) |
|
2010 |
|
|
2009 |
|
|
2010 |
|
|
2009 |
|
Operating revenues: |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Premiums earned, net: |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Premiums earned |
|
$ |
28.1 |
|
|
$ |
26.2 |
|
|
$ |
82.9 |
|
|
$ |
79.1 |
|
Premiums earned ceded |
|
|
(1.4 |
) |
|
|
(1.5 |
) |
|
|
(4.2 |
) |
|
|
(4.6 |
) |
|
|
|
|
|
|
|
|
|
|
|
|
|
Premiums earned, net |
|
|
26.7 |
|
|
|
24.7 |
|
|
|
78.7 |
|
|
|
74.5 |
|
Net investment income |
|
|
4.5 |
|
|
|
4.1 |
|
|
|
12.9 |
|
|
|
12.5 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Total operating revenues |
|
|
31.2 |
|
|
|
28.8 |
|
|
|
91.6 |
|
|
|
87.0 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Operating costs: |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Policy benefits and claims incurred |
|
|
12.8 |
|
|
|
12.2 |
|
|
|
37.1 |
|
|
|
37.9 |
|
Underwriting and other expenses |
|
|
13.8 |
|
|
|
12.6 |
|
|
|
41.4 |
|
|
|
38.2 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Total operating costs |
|
|
26.6 |
|
|
|
24.8 |
|
|
|
78.5 |
|
|
|
76.1 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Operating income |
|
$ |
4.6 |
|
|
$ |
4.0 |
|
|
$ |
13.1 |
|
|
$ |
10.9 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Additional data: |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Loss ratio |
|
|
47.9 |
% |
|
|
49.4 |
% |
|
|
47.1 |
% |
|
|
50.9 |
% |
Operating expense ratio |
|
|
51.7 |
% |
|
|
51.0 |
% |
|
|
52.6 |
% |
|
|
51.3 |
% |
Three Months Ended September 30, 2010 Compared to Three Months Ended September 30, 2009
Operating Revenues
Premiums earned, net for the three months ended September 30, 2010 increased by $2.0 million,
or 8.1% to $26.7 million when compared to the three months ended the September 30, 2009. Such
increase is primarily related to higher sales in the Cancer Protection line of business.
Policy Benefits and Claims Incurred
Policy benefits and claims incurred for the three months ended September 30, 2010 increased by
$0.6 million, or 4.9%, to $12.8 million when compared to the three months ended September 30, 2009,
mostly resulting from the higher volume experienced in the Cancer Protection line of business. The
loss ratio for the period improved from 49.4% in 2009 to 47.9% in 2010, or 1.5 percentage points.
The lower loss ratio is primarily the result of lower death benefits incurred during this period as
compared to 2009.
39
Underwriting and Other Expenses
Underwriting and other expenses for the three month period ended September 30, 2010 increased
$1.2 million, or 9.5%, to $13.8 million when compared to the three months ended September 30, 2009.
The increase is mostly related to a higher amortization of deferred policy acquisition costs. The
increased operating expenses resulted in a higher operating expense ratio, which increased by 0.7
percentage points from 51.0% in 2009 to 51.7% in 2010.
Nine Months Ended September 30, 2010 Compared to Nine Months Ended September 30, 2009
Operating Revenues
Premiums earned, net increased by $4.2 million, or 5.6% to $78.7 million during the nine
months ended September 30, 2010 primarily as the result of higher sales in the Cancer Protection
and Individual Life lines of business, which increased by $2.4 and $1.8 million, respectively.
Policy Benefits and Claims Incurred
Policy benefits and claims incurred decreased by $0.8 million, or 2.1%, to $37.1 million
during the nine months ended September 30, 2010. This decrease is mostly related to a reduction in
the change in the liability for future policy benefits when compared to the same period in 2009
resulting from a change in the mix of business subscribed by the segment. As a result of the
reduction in policy benefits, the loss ratio improved by 3.8 percentage points, from 50.9% in 2009
to 47.1% in 2010.
Underwriting and Other Expenses
Operating expenses increased $3.2 million, or 8.4%, to $41.4 million during the nine months
ended September 30, 2010. The increase is mostly related to a higher amortization of deferred
policy acquisition costs. The higher operating expenses increased the operating expense ratio by
1.3 percentage points, from 51.3% in 2009 to 52.6% in 2010.
Property and Casualty Insurance Operating Results
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Three months ended |
|
|
Nine months ended |
|
|
|
September 30, |
|
|
September 30, |
|
(Dollar amounts in millions) |
|
2010 |
|
|
2009 |
|
|
2010 |
|
|
2009 |
|
Operating revenues: |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Premiums earned, net: |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Premiums written |
|
$ |
40.7 |
|
|
$ |
40.1 |
|
|
$ |
111.5 |
|
|
$ |
110.8 |
|
Premiums ceded |
|
|
(17.4 |
) |
|
|
(15.5 |
) |
|
|
(46.7 |
) |
|
|
(45.0 |
) |
Change in unearned premiums |
|
|
1.2 |
|
|
|
(0.2 |
) |
|
|
10.4 |
|
|
|
7.2 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Premiums earned, net |
|
|
24.5 |
|
|
|
24.4 |
|
|
|
75.2 |
|
|
|
73.0 |
|
Net investment income |
|
|
2.6 |
|
|
|
3.0 |
|
|
|
8.2 |
|
|
|
8.8 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Total operating revenues |
|
|
27.1 |
|
|
|
27.4 |
|
|
|
83.4 |
|
|
|
81.8 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Operating costs: |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Claims incurred |
|
|
11.2 |
|
|
|
13.7 |
|
|
|
37.5 |
|
|
|
36.9 |
|
Underwriting and other expenses |
|
|
13.7 |
|
|
|
13.5 |
|
|
|
42.6 |
|
|
|
40.5 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Total operating costs |
|
|
24.9 |
|
|
|
27.2 |
|
|
|
80.1 |
|
|
|
77.4 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Operating income |
|
$ |
2.2 |
|
|
$ |
0.2 |
|
|
$ |
3.3 |
|
|
$ |
4.4 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Additional data: |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Loss ratio |
|
|
45.7 |
% |
|
|
56.1 |
% |
|
|
49.9 |
% |
|
|
50.5 |
% |
Operating expense ratio |
|
|
55.9 |
% |
|
|
55.3 |
% |
|
|
56.6 |
% |
|
|
55.5 |
% |
Three Months Ended September 30, 2010 Compared to Three Months Ended September 30, 2009
Operating Revenues
Total premiums written during the three months ended September 30, 2010 increased by $0.6
million, or 1.5%, to $40.7 million, mostly resulting from new sales in the Commercial Multi-Peril
and General Liability lines of
40
business. The commercial business continues under soft market
conditions, thus reducing premium rates and increasing competition for renewals and new business.
Premiums ceded to reinsurers during the three months ended September 30, 2010 increased by
approximately $1.9 million, or 12.3% to $17.4 million. The ratio of premiums ceded to premiums
written increased by 3.8 percentage points, from 38.7% in 2009 to 42.5% in 2010, mostly due to an
increase in facultative reinsurance cessions, which represented 5.2 percentage points of the
increase experienced during 2010. This was partially offset by a decrease in the Commercial and
Personal lines quota share treaties of 3.0 and 2.2 percentage points, respectively.
The change in unearned premiums presented an increase of $1.4 million, to $1.2 million during
the three months ended September 30, 2010, primarily as the result of the amortization of premiums
written in prior periods.
Claims Incurred
Claims incurred during the three months ended September 30, 2010 decreased by $2.5 million, or
18.2%, to $11.2 million. The loss ratio decreased by 10.4 percentage points, to 45.7% during the
three months ended September 30, 2010 as a result of favorable loss experience in the Commercial
Multi-Peril, Commercial Auto and Dwelling and Property Monoline lines of business resulting from
lower claim amounts in the claims reported during the current period.
Underwriting and Other Expenses
Underwriting and other operating expenses for the three months ended September 30, 2010
increased by $0.2 million, or 1.5%, to $13.7 million. The operating expense ratio increased by 0.6
percentage points during the same period, to 55.9% in 2010. This fluctuation is primarily due to
an increase of $0.1 million in net commission mostly driven by the higher premium volume during
this quarter.
Nine Months Ended September 30, 2010 Compared to Nine Months Ended September 30, 2009
Operating Revenues
Total premiums written during the nine-month period ended September 30, 2010 increased by $0.7
million, or 0.6%, to $111.5 million. This fluctuation is primarily due to increases in the General
Liability, Personal Auto and Dwelling and Commercial Property Mono-Line lines of business,
partially offset by decreases in premiums written in the Medical Malpractice and Commercial
Multi-Peril lines of business.
Premiums ceded to reinsurers during the nine months ended September 30, 2010 increased by
approximately $1.7 million, or 3.8%, to $46.7 million. The ratio of premiums ceded to premiums
written increased by 1.3 percentage points, from 40.6% in 2009 to 41.9% in 2010. This fluctuation
results from higher facultative reinsurance cessions, which represented 1.9 percentage points of
the increase experienced during the period. This was partially offset by a decrease in the
reinsurance rates for the quota share contracts for commercial and personal property insurance
risks by 3.0 and 2.2 percentage points, respectively.
The change in unearned premiums presented an increase of $3.2 million, to $10.4 million during
the nine months ended September 30, 2010, primarily as the result of the result of the lower volume
of premiums written when compared to the premiums written during the last six months of the year
ended December 31, 2009.
Claims incurred
Claims incurred during the nine months ended September 30, 2010 increased by $0.6 million, or
1.6%, to $37.5 million. The loss ratio decreased by 0.6 percentage points, to 49.9% during the
nine months ended September 30, 2010, primarily due to favorable loss experience in the Dwelling
and Property Monoline, the Medical Malpractice and the Personal Auto lines of business.
Underwriting and other expenses
Underwriting and other operating expenses for the nine months ended September 30, 2010
increased by $2.1 million, or 5.2%, to $42.6 million. This increase is primarily due to higher net
commissions by approximately $1.4 million due to a higher amortization of deferred acquisition
costs due to the lower volume experienced in the 2010 period. The operating expense ratio
increased by 1.1 percentage points, from 55.5% in 2009 to 56.6% in 2010.
41
Liquidity and Capital Resources
Cash Flows
A summary of our major sources and uses of cash for the periods indicated is presented in the
following table:
|
|
|
|
|
|
|
|
|
|
|
Nine months ended |
|
|
|
September 30, |
|
(Dollar amounts in millions) |
|
2010 |
|
|
2009 |
|
Sources of cash: |
|
|
|
|
|
|
|
|
Cash provided by operating activities |
|
$ |
87.0 |
|
|
$ |
66.7 |
|
Proceeds from policyholder deposits |
|
|
7.7 |
|
|
|
3.7 |
|
|
|
|
|
|
|
|
Total sources of cash |
|
|
94.7 |
|
|
|
70.4 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Uses of cash: |
|
|
|
|
|
|
|
|
Net purchases of investment securities |
|
|
(59.4 |
) |
|
|
(6.8 |
) |
Capital expenditures |
|
|
(13.7 |
) |
|
|
(14.7 |
) |
Repurchase and retirement of common stock |
|
|
|
|
|
|
(22.0 |
) |
Payments of long-term borrowings |
|
|
(1.2 |
) |
|
|
(1.2 |
) |
Surrenders of policyholder deposits |
|
|
(7.6 |
) |
|
|
(4.9 |
) |
Other |
|
|
(2.5 |
) |
|
|
(12.2 |
) |
|
|
|
|
|
|
|
Total uses of cash |
|
|
(84.4 |
) |
|
|
(61.8 |
) |
|
|
|
|
|
|
|
Net increase in cash and cash equivalents |
|
$ |
10.3 |
|
|
$ |
8.6 |
|
|
|
|
|
|
|
|
Cash flow from operating activities increased by $20.3 million for the nine months ended
September 30, 2010 as compared to the nine months ended September 30, 2009, principally due to the
effect of an increase in premiums collected of $81.8 and a decrease in income taxes paid of $13.6.
These fluctuations were offset in part by an increase in claims paid of $59.8 million and an
increase in cash paid to suppliers and employees of $4.4 million. The increase in claims paid and
in premiums collected is primarily the result of higher volume in our Managed Care segment, mainly
in the member months enrollment of the Commercial business.
Net acquisition of investment securities increased by $52.6 million during the nine months
ended September 30, 2010, when compared to same period the prior year primarily as the result of
the purchase of investments classified as available-for-sale with cash generated from operations.
The decrease in the other uses of cash of $9.7 million is attributed to changes in the amount
of outstanding checks over bank balances in the 2010 period.
On December 8, 2008 we announced the immediate commencement of a $40.0 million share
repurchase program. We paid approximately $22.0 million under the stock repurchase program during
the nine months ended September 30, 2009. This share repurchase program was completed in December
1, 2009.
Share Repurchase Program
On September 29, 2010, we announced the immediate commencement of a $30.0 million share
repurchase program. The program will be conducted using available cash through open-market
purchases and privately-negotiated transactions of Class B shares only, in accordance with Rules
10b-18 and 10b5-1 under the Securities Exchange Act of 1934, as amended. During the three months
ended September 30, 2010 we repurchased and retired 24,400 shares at an average per share price of
$16.61, for an aggregate cost of $0.4 million. At September 30, 2010 these shares repurchases
remained unsettled and were included within the accounts payable and accrued liabilities in the
accompanying consolidated balance sheet.
Financing and Financing Capacity
We have several short-term facilities available to address timing differences between cash
receipts and disbursements. These short-term facilities are mostly in the form of arrangements to
sell securities under repurchase agreements. As of September 30, 2010, we had $110.0 million of
available credit under these facilities.
As of September 30, 2010, we had the following senior unsecured notes payable:
|
|
On January 31, 2006, we issued and sold $35.0 million of our 6.7% senior unsecured notes payable due January 2021 (the 6.7%
notes). |
42
|
|
On December 21, 2005, we issued and sold $60.0 million of our 6.6% senior unsecured notes due December 2020 (the 6.6%
notes). During September 2010, we entered into an agreement to purchase $25.0 million of this note on October 1, 2010.
For additional information refer to note 7 of the unaudited consolidated financial statements. |
|
|
|
On September 30, 2004, we issued and sold $50.0 million of our 6.3% senior unsecured notes due September 2019 (the 6.3%
notes). |
The 6.3% notes, the 6.6% notes and the 6.7% notes contain certain non-financial covenants. At
September 30, 2010, we and our managed care subsidiary, as applicable, are in compliance with these
covenants.
In addition, we are a party to a secured term loan with a commercial bank in Puerto Rico.
This secured loan bears interest at a rate equal to the London Interbank Offered Rate (LIBOR) plus
100 basis points and requires monthly principal repayments of $0.1 million. As of September 30,
2010, this secured loan had an outstanding balance of $21.4 million and average annual interest
rate of 1.37%.
This secured loan is guaranteed by a first lien on our land, buildings and substantially all
leasehold improvements, as collateral for the term of the agreements under a continuing general
security agreement. This secured loan contains certain non-financial covenants that are customary
for this type of facility, including, but not limited to, restrictions on the granting of certain
liens, limitations on acquisitions and limitations on changes in control. As of September 30, 2010
we are in compliance with these covenants. Failure to meet these covenants may trigger the
accelerated payment of the secured loans outstanding balance.
We anticipate that we will have sufficient liquidity to support our currently expected needs.
Further details regarding the senior unsecured notes and the credit agreements are
incorporated by reference to Item 7.Management Discussion and Analysis of Financial Condition
and Results of Operations included in our Annual Report on Form 10-K for the year ended December
31, 2009.
Item 3. Quantitative and Qualitative Disclosures about Market Risk
We are exposed to certain market risks that are inherent in our financial instruments,
which arise from transactions entered into in the normal course of business. We have exposure to
market risk mostly in our investment activities. For purposes of this disclosure, market risk is
defined as the risk of loss resulting from changes in interest rates and equity prices. No
material changes have occurred in our exposure to financial market risks since December 31, 2009.
A discussion of our market risk is incorporated by reference to Item 7A. Quantitative and
Qualitative Disclosures about Market Risk of our Annual Report on Form 10-K for the year ended
December 31, 2009.
Item 4. Controls and Procedures
Evaluation of Disclosure Controls and Procedures
In connection with the preparation of this Quarterly Report on Form 10-Q, management, under
the supervision and with the participation of the chief executive officer and chief financial
officer, conducted an evaluation of the effectiveness of our disclosure controls and procedures
(as such term is defined under Exchange Act Rule 13a-15(e)). Disclosure controls and procedures
are designed to ensure that information required to be disclosed in reports filed or submitted
under the Exchange Act is recorded, processed, summarized and reported within the time periods
specified in Securities and Exchange
Commission rules and forms and that such information is accumulated and communicated to
management, including the chief executive officer and chief financial officer, to allow timely
decisions regarding required disclosures. A control system, no matter how well conceived and
operated, can provide only reasonable, not absolute, assurance that the objectives of the control
system are met. There are inherent limitations to the effectiveness of any system of disclosure
controls and procedures, including the possibility that judgments in decision-making can be faulty,
and breakdowns as a result of simple errors or mistake. Accordingly, even effective disclosure
controls and procedures can only provide reasonable assurance of achieving their control
objectives. The design of any system of controls also is based in part upon certain assumptions
about the likelihood of future events, and there can be no assurance that any design will succeed
in achieving its stated goals under all potential future conditions.
43
Based on this evaluation, our chief executive officer and chief financial officer have
concluded that as of September 30, 2010, which is the end of the period covered by this Quarterly
Report on Form 10-Q, our disclosure controls and procedures are effective to a reasonable level of
assurance.
There were no significant changes in our disclosure controls and procedures, or in factors
that could significantly affect internal controls, subsequent to the date the chief executive
officer and chief financial officer completed the evaluation referred to above.
Changes in Internal Controls Over Financial Reporting
No changes in our internal control over financial reporting (as such term is defined in
Exchange Act Rule 13a-15(f)) occurred during the fiscal quarter ended September 30, 2010 that
materially affected, or is reasonably likely to materially affect, our internal control over
financial reporting.
Part II Other Information
Item 1. Legal Proceedings
For a description of legal proceedings, see note 14 to the unaudited consolidated
financial statements included in this quarterly report on Form 10-Q.
Item 1A. Risk Factors
For a description of our risk factors see Item 1A of Part I of our Annual Report on Form
10-K for the year ended December 31, 2009. See also section Recent Developments Federal Health
Reform Legislation in Item 2 of Part I of this Quarterly Report on Form 10-Q.
Item 2. Unregistered Sales of Equity Securities and Use of Proceeds
Purchases of Equity Securities by the Issuer
The following table presents information related to our repurchases of common stock for the
period indicated:
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Total Number |
|
|
Approximate |
|
|
|
|
|
|
|
|
|
|
|
of Shares |
|
|
Dollar Value |
|
|
|
|
|
|
|
|
|
|
|
Purchased as |
|
|
of Shares that |
|
|
|
Total |
|
|
|
|
|
|
Part of |
|
|
May Yet Be |
|
|
|
Number of |
|
|
Average |
|
|
Publicly |
|
|
Purchased |
|
(Dollar amounts in millions, except |
|
Shares |
|
|
Price Paid |
|
|
Announced |
|
|
Under the |
|
per share data) |
|
Purchased |
|
|
per Share |
|
|
Programs1 |
|
|
Programs |
|
September 1, 2010 to September 30,
2010 |
|
|
24,400 |
|
|
$ |
16.61 |
|
|
|
24,400 |
|
|
$ |
29.6 |
|
|
|
|
1 |
|
On September 29, 2010, the Board of Directors authorized the immediate
commencement of a $30.0 million share repurchase program of Class B shares only. |
Item 3. Defaults Upon Senior Securities
Not applicable.
Item 4. (Removed and Reserved)
Item 5. Other Information
Not applicable.
44
Item 6. Exhibits
|
|
|
Exhibits |
|
Description |
Exhibit 3(ii)
|
|
Amended and Restated Bylaws of Triple-S Management
Corporation (incorporated herein by reference to Exhibit 3.1
to TSMs Current Report on Form 8-K filed on June 11, 2010
(File No. 001-33865)). |
|
|
|
Exhibit 10.1
|
|
Extension to the agreement between the Puerto Rico Health
Insurance Administration and TSS for the provision of health
insurance coverage to eligible population in the North and
South-West Regions until June 30, 2010 (incorporated herein
by reference to Exhibit 10.1 to TSMs Quarterly Report on
Form 10-Q for the quarter ended June 30, 2010 (File No.
001-33865)). |
|
|
|
Exhibit 10.2
|
|
Extension to the agreement between the Puerto Rico Health
Insurance Administration and TSS to act as third party
administrator in the Metro-North Region until September 30,
2010 (incorporated herein by reference to Exhibit 10.1 to
TSMs Quarterly Report on Form 10-Q for the quarter ended
June 30, 2010 (File No. 001-33865)). |
|
|
|
Exhibit 10.3
|
|
Extension to the agreement between the Puerto Rico Health
Insurance Administration and TSS for the provision of health
insurance coverage to eligible population in the North and
South-West Regions until September 30, 2010 (incorporated
herein by reference to Exhibit 10.1 to TSMs Quarterly
Report on Form 10-Q for the quarter ended June 30, 2010
(File No. 001-33865)). |
|
|
|
Exhibit 10.4*
|
|
Amendment to the Medicare Platino Contract (Medicare
Wraparound) between the Puerto Rico Health Insurance
Administration and TSS for the provision of wraparound
coverage to health insurance dual-eligible population until
December 31, 2011. |
|
|
|
11
|
|
Statement re computation of per share earnings; an exhibit
describing the computation of the earnings per share for the
three months and six months ended September 30, 2010 and
2009 has been omitted as the detail necessary to determine
the computation of earnings per share can be clearly
determined from the material contained in Part I of this
Quarterly Report on Form 10-Q. |
|
|
|
31.1*
|
|
Certification of the President and Chief Executive Officer
required by Rule 13a-14(a)/15d-14(a). |
|
|
|
31.2*
|
|
Certification of the Vice President of Finance and Chief
Financial Officer required by Rule 13a-14(a)/15d-14(a). |
|
|
|
32.1*
|
|
Certification of the President and Chief Executive Officer
required pursuant to 18 U.S.C Section 1350. |
|
|
|
32.2*
|
|
Certification of the Vice President of Finance and Chief
Financial Officer required pursuant to 18 U.S.C Section
1350. |
All other exhibits for which provision is made in the applicable accounting regulation of the
United States Securities and Exchange Commission are not required under the related instructions or
are inapplicable, and therefore have been omitted.
45
SIGNATURES
Pursuant to the requirements of the United States Securities and Exchange Act of 1934,
the registrant has duly caused this report to be signed on its behalf by the undersigned thereunto
duly authorized.
|
|
|
|
|
|
Triple-S Management Corporation
Registrant
|
|
Date: November 9, 2010 |
By: |
/s/ Ramón M. Ruiz-Comas
|
|
|
|
Ramón M. Ruiz-Comas, CPA |
|
|
|
President and
Chief Executive Officer |
|
|
|
|
Date: November 9, 2010 |
By: |
/s/ Juan J. Román
|
|
|
|
Juan J. Román, CPA |
|
|
|
Vice President of Finance
and Chief Financial Officer
Principal Accounting Officer |
|
46