☑ | QUARTERLY REPORT PURSUANT TO SECTION 13 OR 15(D) OF THE SECURITIES EXCHANGE ACT OF 1934 |
☐ | TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(D) OF THE SECURITIES EXCHANGE ACT OF 1934 |
Puerto Rico
|
66-0555678
|
|
(State or other jurisdiction of incorporation or organization)
|
(I.R.S. Employer Identification No.)
|
|
1441 F.D. Roosevelt Avenue
|
||
San Juan, Puerto Rico
|
00920
|
|
(Address of principal executive offices)
|
(Zip code)
|
Large accelerated filer ☐
|
Accelerated filer ☑
|
|
Non-accelerated filer ☐
|
Smaller reporting company ☐
|
Title of each class
|
Outstanding at June 30, 2016
|
|
Common Stock Class A, $1.00 par value
|
950,968
|
|
Common Stock Class B, $1.00 par value
|
23,622,795
|
Part I – Financial Information | 3 | ||
Item 1. | 3 | ||
Item 2. | 30 | ||
30 | |||
30 | |||
31 | |||
32 | |||
33 | |||
33 | |||
36 | |||
39 | |||
40 | |||
41 | |||
Item 3. | 42 | ||
Item 4. | 43 | ||
Part II – Other Information | 43 | ||
Item 1. | 43 | ||
Item 1A. | 43 | ||
Item 2. | 44 | ||
Item 3. | 44 | ||
Item 4. | 44 | ||
Item 5. | 44 | ||
Item 6. | 44 | ||
SIGNATURES | 45 |
June 30,
|
December 31,
|
|||||||
2016
|
2015
|
|||||||
Assets
|
||||||||
Investments and cash:
|
||||||||
Securities available for sale, at fair value:
|
||||||||
Fixed maturities
|
$
|
1,144,588
|
$
|
1,133,645
|
||||
Equity securities
|
310,103
|
197,071
|
||||||
Securities held to maturity, at amortized cost:
|
||||||||
Fixed maturities
|
2,838
|
2,929
|
||||||
Policy loans
|
8,301
|
7,901
|
||||||
Cash and cash equivalents
|
96,140
|
197,818
|
||||||
Total investments and cash
|
1,561,970
|
1,539,364
|
||||||
Premiums and other receivables, net
|
348,204
|
282,646
|
||||||
Deferred policy acquisition costs and value of business acquired
|
188,976
|
190,648
|
||||||
Property and equipment, net
|
70,356
|
73,953
|
||||||
Deferred tax asset
|
46,716
|
52,361
|
||||||
Goodwill
|
25,397
|
25,397
|
||||||
Other assets
|
73,675
|
41,776
|
||||||
Total assets
|
$
|
2,315,294
|
$
|
2,206,145
|
||||
Liabilities and Equity
|
||||||||
Claim liabilities
|
$
|
481,864
|
$
|
491,765
|
||||
Liability for future policy benefits
|
309,491
|
289,530
|
||||||
Unearned premiums
|
82,051
|
80,260
|
||||||
Policyholder deposits
|
182,730
|
179,287
|
||||||
Liability to Federal Employees' Health Benefits Program (FEHBP)
|
24,554
|
26,695
|
||||||
Accounts payable and accrued liabilities
|
229,860
|
176,910
|
||||||
Deferred tax liability
|
24,745
|
15,070
|
||||||
Long-term borrowings
|
36,007
|
36,827
|
||||||
Liability for pension benefits
|
65,229
|
62,945
|
||||||
Total liabilities
|
1,436,531
|
1,359,289
|
||||||
Stockholders’ equity:
|
||||||||
Triple-S Management Corporation stockholders' equity
|
||||||||
Common stock Class A, $1 par value. Authorized 100,000,000 shares; issued and outstanding 950,968 at June 30, 2016 and December 31, 2015, respectively
|
951
|
951
|
||||||
Common stock Class B, $1 par value. Authorized 100,000,000 shares; issued and outstanding 23,622,795 and 24,047,755 shares at June 30, 2016 and December 31, 2015, respectively
|
23,623
|
24,048
|
||||||
Additional paid-in capital
|
71,951
|
83,438
|
||||||
Retained earnings
|
720,802
|
713,466
|
||||||
Accumulated other comprehensive income
|
62,109
|
25,623
|
||||||
Total Triple-S Management Corporation stockholders' equity
|
879,436
|
847,526
|
||||||
Non-controlling interest in consolidated subsidiary
|
(673
|
)
|
(670
|
)
|
||||
Total stockholders' equity
|
878,763
|
846,856
|
||||||
Total liabilities and equity
|
$
|
2,315,294
|
$
|
2,206,145
|
Three months ended
June 30, |
Six months ended
June 30, |
|||||||||||||||
2016
|
2015
|
2016
|
2015
|
|||||||||||||
Revenues:
|
||||||||||||||||
Premiums earned, net
|
$
|
729,049
|
$
|
754,107
|
$
|
1,467,583
|
$
|
1,286,665
|
||||||||
Administrative service fees
|
4,520
|
4,549
|
9,603
|
33,672
|
||||||||||||
Net investment income
|
12,875
|
10,998
|
24,233
|
21,916
|
||||||||||||
Other operating revenues
|
915
|
641
|
1,727
|
1,794
|
||||||||||||
Total operating revenues
|
747,359
|
770,295
|
1,503,146
|
1,344,047
|
||||||||||||
Net realized investment gains (losses):
|
||||||||||||||||
Total other-than-temporary impairment losses on securities
|
(1,434
|
)
|
(1,660
|
)
|
(1,434
|
)
|
(2,862
|
)
|
||||||||
Net realized gains, excluding other-than-temporary impairment losses on securities
|
2,954
|
12,267
|
3,012
|
19,682
|
||||||||||||
Total net realized investment gains on sale of securities
|
1,520
|
10,607
|
1,578
|
16,820
|
||||||||||||
Other income, net
|
3,859
|
1,083
|
4,734
|
2,842
|
||||||||||||
Total revenues
|
752,738
|
781,985
|
1,509,458
|
1,363,709
|
||||||||||||
Benefits and expenses:
|
||||||||||||||||
Claims incurred
|
622,087
|
637,898
|
1,248,781
|
1,070,328
|
||||||||||||
Operating expenses
|
121,112
|
126,824
|
244,092
|
254,199
|
||||||||||||
Total operating costs
|
743,199
|
764,722
|
1,492,873
|
1,324,527
|
||||||||||||
Interest expense
|
1,954
|
2,074
|
3,836
|
4,256
|
||||||||||||
Total benefits and expenses
|
745,153
|
766,796
|
1,496,709
|
1,328,783
|
||||||||||||
Income before taxes
|
7,585
|
15,189
|
12,749
|
34,926
|
||||||||||||
Income tax expense (benefit)
|
3,707
|
(3,712
|
)
|
5,416
|
1,219
|
|||||||||||
Net income
|
3,878
|
18,901
|
7,333
|
33,707
|
||||||||||||
Less: Net loss attributable to non-controlling interest
|
2
|
25
|
3
|
55
|
||||||||||||
Net income attributable to Triple-S Management Corporation
|
$
|
3,880
|
$
|
18,926
|
$
|
7,336
|
$
|
33,762
|
||||||||
Earnings per share attributable to Triple-S Management Corporation
|
||||||||||||||||
Basic net income per share
|
$
|
0.16
|
$
|
0.73
|
$
|
0.30
|
$
|
1.29
|
||||||||
Diluted net income per share
|
$
|
0.16
|
$
|
0.73
|
$
|
0.30
|
$
|
1.28
|
Three months ended
June 30, |
Six months ended
June 30, |
|||||||||||||||
2016
|
2015
|
2016
|
2015
|
|||||||||||||
Net income
|
$
|
3,878
|
$
|
18,901
|
$
|
7,333
|
$
|
33,707
|
||||||||
Other comprehensive income (loss), net of tax:
|
||||||||||||||||
Net unrealized change in fair value of available for sale securities, net of taxes
|
15,830
|
(29,044
|
)
|
35,407
|
(27,250
|
)
|
||||||||||
Defined benefit pension plan:
|
||||||||||||||||
Actuarial loss, net
|
507
|
1,016
|
1,229
|
1,903
|
||||||||||||
Prior service credit, net
|
(62
|
)
|
(77
|
)
|
(150
|
)
|
(138
|
)
|
||||||||
Total other comprehensive income (loss), net of tax
|
16,275
|
(28,105
|
)
|
36,486
|
(25,485
|
)
|
||||||||||
Comprehensive income (loss)
|
20,153
|
(9,204
|
)
|
43,819
|
8,222
|
|||||||||||
Comprehensive loss attributable to non-controlling interest
|
2
|
25
|
3
|
55
|
||||||||||||
Comprehensive income (loss) attributable to Triple-S Management Corporation
|
$
|
20,155
|
$
|
(9,179
|
)
|
$
|
43,822
|
$
|
8,277
|
2016
|
2015
|
|||||||
Balance at January 1
|
$
|
847,526
|
$
|
858,558
|
||||
Share-based compensation
|
2,649
|
3,199
|
||||||
Stock issued upon the exercise of stock options
|
55
|
179
|
||||||
Repurchase and retirement of common stock
|
(14,616
|
)
|
(26,170
|
)
|
||||
Comprehensive income
|
43,822
|
8,277
|
||||||
Total Triple-S Management Corporation stockholders' equity
|
879,436
|
844,043
|
||||||
Non-controlling interest in consolidated subsidiary
|
(673
|
)
|
(587
|
)
|
||||
Balance at June 30
|
$
|
878,763
|
$
|
843,456
|
Six months ended
June 30, |
||||||||
2016
|
2015
|
|||||||
Cash flows from operating activities:
|
||||||||
Net income
|
$
|
7,333
|
$
|
33,707
|
||||
Adjustments to reconcile net income to net cash provided by operating activities:
|
||||||||
Depreciation and amortization
|
7,300
|
8,138
|
||||||
Net amortization of investments
|
3,981
|
3,187
|
||||||
(Reduction) additions to the allowance for doubtful receivables
|
(313
|
)
|
11,626
|
|||||
Deferred tax expense (benefit)
|
4,301
|
(6,423
|
)
|
|||||
Net realized investment gain on sale of securities
|
(1,578
|
)
|
(16,820
|
)
|
||||
Interest credited to policyholder deposits
|
2,436
|
1,742
|
||||||
Share-based compensation
|
2,313
|
3,199
|
||||||
(Increase) decrease in assets:
|
||||||||
Premium and other receivables, net
|
(63,589
|
)
|
(56,003
|
)
|
||||
Deferred policy acquisition costs and value of business acquired
|
(3,562
|
)
|
(2,043
|
)
|
||||
Deferred taxes
|
178
|
(4,876
|
)
|
|||||
Other assets
|
(31,425
|
)
|
(16,596
|
)
|
||||
Increase (decrease) in liabilities:
|
||||||||
Claim liabilities
|
(9,901
|
)
|
72,100
|
|||||
Liability for future policy benefits
|
19,961
|
11,414
|
||||||
Unearned premiums
|
1,791
|
(2,464
|
)
|
|||||
Liability to FEHBP
|
(2,141
|
)
|
823
|
|||||
Accounts payable and accrued liabilities
|
52,350
|
36,017
|
||||||
Net cash (used in) provided by operating activities
|
(10,565
|
)
|
76,728
|
Six months ended
June 30, |
||||||||
2016
|
2015
|
|||||||
Cash flows from investing activities:
|
||||||||
Proceeds from investments sold or matured:
|
||||||||
Securities available for sale:
|
||||||||
Fixed maturities sold
|
$
|
163,150
|
$
|
241,476
|
||||
Fixed maturities matured/called
|
14,301
|
34,906
|
||||||
Equity securities sold
|
32,252
|
65,621
|
||||||
Securities held to maturity - fixed maturities matured/called
|
700
|
100
|
||||||
Acquisition of investments:
|
||||||||
Securities available for sale:
|
||||||||
Fixed maturities
|
(150,005
|
)
|
(259,984
|
)
|
||||
Equity securities
|
(136,104
|
)
|
(12,165
|
)
|
||||
Securities held to maturity - fixed maturities
|
(609
|
)
|
(103
|
)
|
||||
Increase in other investments
|
(1,383
|
)
|
(2,522
|
)
|
||||
Net disbursements for policy loans
|
(400
|
)
|
(74
|
)
|
||||
Net capital expenditures
|
(2,716
|
)
|
(3,003
|
)
|
||||
Net cash (used in) provided by investing activities
|
(80,814
|
)
|
64,252
|
|||||
Cash flows from financing activities:
|
||||||||
Change in outstanding checks in excess of bank balances
|
4,074
|
1,028
|
||||||
Repayments of long-term borrowings
|
(820
|
)
|
(11,820
|
)
|
||||
Repurchase and retirement of common stock
|
(14,560
|
)
|
(25,988
|
)
|
||||
Proceeds from policyholder deposits
|
7,942
|
4,538
|
||||||
Surrenders of policyholder deposits
|
(6,935
|
)
|
(6,271
|
)
|
||||
Net cash used in financing activities
|
(10,299
|
)
|
(38,513
|
)
|
||||
Net (decrease) increase in cash and cash equivalents
|
(101,678
|
)
|
102,467
|
|||||
Cash and cash equivalents:
|
||||||||
Beginning of period
|
197,818
|
110,037
|
||||||
End of period
|
$
|
96,140
|
$
|
212,504
|
(1) | Basis of Presentation |
(2) | Recent Accounting Standards |
(3) | Investment in Securities |
June 30, 2016
|
||||||||||||||||
Amortized
cost |
Gross
unrealized |
Gross
unrealized |
Estimated
fair value |
|||||||||||||
Securities available for sale:
|
||||||||||||||||
Fixed maturities:
|
||||||||||||||||
Obligations of government-sponsored enterprises
|
$
|
70,523
|
$
|
791
|
$
|
-
|
$
|
71,314
|
||||||||
U.S. Treasury securities and obligations of U.S. government instrumentalities
|
95,105
|
1,517
|
-
|
96,622
|
||||||||||||
Obligations of the Commonwealth of Puerto Rico and its instrumentalities
|
25,981
|
2,666
|
-
|
28,647
|
||||||||||||
Municipal securities
|
648,892
|
60,786
|
(5
|
)
|
709,673
|
|||||||||||
Corporate bonds
|
197,493
|
20,776
|
-
|
218,269
|
||||||||||||
Residential mortgage-backed securities
|
775
|
47
|
-
|
822
|
||||||||||||
Collateralized mortgage obligations
|
19,104
|
138
|
(1
|
)
|
19,241
|
|||||||||||
Total fixed maturities
|
1,057,873
|
86,721
|
(6
|
)
|
1,144,588
|
|||||||||||
Equity securities - Mutual funds
|
272,948
|
38,044
|
(889
|
)
|
310,103
|
|||||||||||
Total
|
$
|
1,330,821
|
$
|
124,765
|
$
|
(895
|
)
|
$
|
1,454,691
|
December 31, 2015
|
||||||||||||||||
Amortized
cost |
Gross
unrealized |
Gross
unrealized |
Estimated
fair value |
|||||||||||||
Securities available for sale:
|
||||||||||||||||
Fixed maturities:
|
||||||||||||||||
Obligations of government-sponsored enterprises
|
$
|
115,965
|
$
|
301
|
$
|
(26
|
)
|
$
|
116,240
|
|||||||
U.S. Treasury securities and obligations of U.S. government instrumentalities
|
163,322
|
234
|
(286
|
)
|
163,270
|
|||||||||||
Obligations of the Commonwealth of Puerto Rico and its instrumentalities
|
25,302
|
317
|
-
|
25,619
|
||||||||||||
Municipal securities
|
612,225
|
35,418
|
(197
|
)
|
647,446
|
|||||||||||
Corporate bonds
|
148,198
|
9,782
|
(572
|
)
|
157,408
|
|||||||||||
Residential mortgage-backed securities
|
883
|
54
|
-
|
937
|
||||||||||||
Collateralized mortgage obligations
|
22,363
|
368
|
(6
|
)
|
22,725
|
|||||||||||
Total fixed maturities
|
1,088,258
|
46,474
|
(1,087
|
)
|
1,133,645
|
|||||||||||
Equity securities - Mutual funds
|
169,593
|
27,851
|
(373
|
)
|
197,071
|
|||||||||||
Total
|
$
|
1,257,851
|
$
|
74,325
|
$
|
(1,460
|
)
|
$
|
1,330,716
|
June 30, 2016
|
||||||||||||||||
Amortized
cost |
Gross
unrealized |
Gross
unrealized |
Estimated
fair value |
|||||||||||||
Securities held to maturity:
|
||||||||||||||||
U.S. Treasury securities and obligations of U.S. government instrumentalities
|
$
|
620
|
$
|
238
|
$
|
-
|
$
|
858
|
||||||||
Residential mortgage-backed securities
|
191
|
20
|
-
|
211
|
||||||||||||
Certificates of deposit
|
2,027
|
-
|
-
|
2,027
|
||||||||||||
Total
|
$
|
2,838
|
$
|
258
|
$
|
-
|
$
|
3,096
|
December 31, 2015
|
||||||||||||||||
Amortized
cost |
Gross
unrealized |
Gross
unrealized |
Estimated
fair value |
|||||||||||||
Securities held to maturity:
|
||||||||||||||||
U.S. Treasury securities and obligations of U.S. government instrumentalities
|
$
|
620
|
$
|
178
|
$
|
-
|
$
|
798
|
||||||||
Residential mortgage-backed securities
|
191
|
17
|
-
|
208
|
||||||||||||
Certificates of deposit
|
2,118
|
-
|
-
|
2,118
|
||||||||||||
Total
|
$
|
2,929
|
$
|
195
|
$
|
-
|
$
|
3,124
|
June 30, 2016
|
||||||||||||||||||||||||||||||||||||
Less than 12 months
|
12 months or longer
|
Total
|
||||||||||||||||||||||||||||||||||
Estimated
Fair Value |
Gross
Unrealized |
Number of
Securities |
Estimated
Fair Value |
Gross
Unrealized |
Number of
Securities |
Estimated
Fair Value |
Gross
Unrealized |
Number of
Securities |
||||||||||||||||||||||||||||
Securites available for sale
|
||||||||||||||||||||||||||||||||||||
Fixed maturities
|
||||||||||||||||||||||||||||||||||||
Municipal securities
|
$
|
7,857
|
$
|
(5
|
)
|
1
|
$
|
-
|
$
|
-
|
-
|
$
|
7,857
|
$
|
(5
|
)
|
1
|
|||||||||||||||||||
Collateralized mortgage obligations
|
1,117
|
(1
|
)
|
1
|
-
|
-
|
-
|
1,117
|
(1
|
)
|
1
|
|||||||||||||||||||||||||
Total fixed maturities
|
8,974
|
(6
|
)
|
2
|
-
|
-
|
-
|
8,974
|
(6
|
)
|
2
|
|||||||||||||||||||||||||
Equity securities-Mutual funds
|
21,569
|
(889
|
)
|
6
|
-
|
-
|
-
|
21,569
|
(889
|
)
|
6
|
|||||||||||||||||||||||||
Total for securities available for sale
|
$
|
30,543
|
$
|
(895
|
)
|
8
|
$
|
-
|
$
|
-
|
-
|
$
|
30,543
|
$
|
(895
|
)
|
8
|
December 31, 2015
|
||||||||||||||||||||||||||||||||||||
Less than 12 months
|
12 months or longer
|
Total
|
||||||||||||||||||||||||||||||||||
Estimated
Fair Value |
Gross
Unrealized |
Number of
Securities |
Estimated
Fair Value |
Gross
Unrealized |
Number of
Securities |
Estimated
Fair Value |
Gross
Unrealized |
Number of
Securities |
||||||||||||||||||||||||||||
Securites available for sale
|
||||||||||||||||||||||||||||||||||||
Fixed maturities
|
||||||||||||||||||||||||||||||||||||
Obligations of government-sponsored enterprises
|
$
|
18,989
|
$
|
(26
|
)
|
1
|
$
|
-
|
$
|
-
|
-
|
$
|
18,989
|
$
|
(26
|
)
|
1
|
|||||||||||||||||||
U.S. Treasury securities and obligations of U.S. governmental instrumentalities
|
130,996
|
(286
|
)
|
5
|
-
|
-
|
-
|
130,996
|
(286
|
)
|
5
|
|||||||||||||||||||||||||
Municipal securities
|
43,937
|
(197
|
)
|
11
|
-
|
-
|
-
|
43,937
|
(197
|
)
|
11
|
|||||||||||||||||||||||||
Corporate bonds
|
35,718
|
(572
|
)
|
9
|
-
|
-
|
-
|
35,718
|
(572
|
)
|
9
|
|||||||||||||||||||||||||
Collateralized mortgage obligations
|
1,448
|
(6
|
)
|
1
|
-
|
-
|
-
|
1,448
|
(6
|
)
|
1
|
|||||||||||||||||||||||||
Total fixed maturities
|
231,088
|
(1,087
|
)
|
27
|
-
|
-
|
-
|
231,088
|
(1,087
|
)
|
27
|
|||||||||||||||||||||||||
Equity securities-Mutual funds
|
9,319
|
(373
|
)
|
2
|
-
|
-
|
-
|
9,319
|
(373
|
)
|
2
|
|||||||||||||||||||||||||
Total for securities available for sale
|
$
|
240,407
|
$
|
(1,460
|
)
|
29
|
$
|
-
|
$
|
-
|
-
|
$
|
240,407
|
$
|
(1,460
|
)
|
29
|
June 30, 2016
|
||||||||
Amortized
cost |
Estimated
fair value |
|||||||
Securities available for sale:
|
||||||||
Due in one year or less
|
$
|
43,982
|
$
|
44,305
|
||||
Due after one year through five years
|
329,658
|
338,835
|
||||||
Due after five years through ten years
|
109,413
|
122,168
|
||||||
Due after ten years
|
554,941
|
619,217
|
||||||
Residential mortgage-backed securities
|
775
|
822
|
||||||
Collateralized mortgage obligations
|
19,104
|
19,241
|
||||||
$
|
1,057,873
|
$
|
1,144,588
|
|||||
Securities held to maturity:
|
||||||||
Due in one year or less
|
$
|
2,027
|
$
|
2,027
|
||||
Due after ten years
|
620
|
858
|
||||||
Residential mortgage-backed securities
|
191
|
211
|
||||||
$
|
2,838
|
$
|
3,096
|
Three months ended
June 30, |
Six months ended
June 30, |
|||||||||||||||
2016
|
2015
|
2016
|
2015
|
|||||||||||||
Realized gains (losses):
|
||||||||||||||||
Fixed maturity securities:
|
||||||||||||||||
Securities available for sale:
|
||||||||||||||||
Gross gains from sales
|
$
|
912
|
$
|
2,328
|
$
|
1,873
|
$
|
6,337
|
||||||||
Gross losses from sales
|
(103
|
)
|
(129
|
)
|
(1,462
|
)
|
(404
|
)
|
||||||||
Gross losses from other-than-temporary impairments
|
-
|
(1,660
|
)
|
-
|
(2,862
|
)
|
||||||||||
Total fixed maturity securities
|
809
|
539
|
411
|
3,071
|
||||||||||||
Equity securities:
|
||||||||||||||||
Securities available for sale:
|
||||||||||||||||
Gross gains from sales
|
2,525
|
10,138
|
3,112
|
13,874
|
||||||||||||
Gross losses from sales
|
(380
|
)
|
(70
|
)
|
(511
|
)
|
(125
|
)
|
||||||||
Gross losses from other-than-temporary impairments
|
(1,434
|
)
|
-
|
(1,434
|
)
|
-
|
||||||||||
Total equity securities
|
711
|
10,068
|
1,167
|
13,749
|
||||||||||||
Net realized gains on securities available for sale
|
$
|
1,520
|
$
|
10,607
|
$
|
1,578
|
$
|
16,820
|
Three months ended
June 30, |
Six months ended
June 30, |
|||||||||||||||
2016
|
2015
|
2016
|
2015
|
|||||||||||||
Changes in net unrealized gains (losses):
|
||||||||||||||||
Recognized in accumulated other comprehensive income:
|
||||||||||||||||
Fixed maturities – available for sale
|
$
|
18,739
|
$
|
(23,848
|
)
|
$
|
41,328
|
$
|
(19,757
|
)
|
||||||
Equity securities – available for sale
|
2,908
|
(11,595
|
)
|
9,677
|
(12,873
|
)
|
||||||||||
$
|
21,647
|
$
|
(35,443
|
)
|
$
|
51,005
|
$
|
(32,630
|
)
|
|||||||
Not recognized in the consolidated financial statements:
|
||||||||||||||||
Fixed maturities – held to maturity
|
$
|
27
|
$
|
(37
|
)
|
$
|
63
|
$
|
(20
|
)
|
(4) | Premiums and Other Receivables, Net |
June 30,
2016 |
December 31,
2015 |
|||||||
Premium
|
$
|
137,649
|
$
|
92,600
|
||||
Self-funded group receivables
|
66,724
|
73,552
|
||||||
FEHBP
|
14,129
|
13,859
|
||||||
Agent balances
|
31,934
|
25,424
|
||||||
Accrued interest
|
13,102
|
12,624
|
||||||
Reinsurance recoverable
|
56,941
|
48,506
|
||||||
Other
|
63,928
|
53,325
|
||||||
384,407
|
319,890
|
|||||||
Less allowance for doubtful receivables:
|
||||||||
Premium
|
27,805
|
28,944
|
||||||
Other
|
8,398
|
8,300
|
||||||
36,203
|
37,244
|
|||||||
Total premium and other receivables, net
|
$
|
348,204
|
$
|
282,646
|
(5) | Fair Value Measurements |
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 management’s best estimate of what market participants would use in pricing the asset or liability at the measurement date.
|
June 30, 2016
|
||||||||||||||||
Level 1
|
Level 2
|
Level 3
|
Total
|
|||||||||||||
Securities available for sale:
|
||||||||||||||||
Fixed maturity securities
|
||||||||||||||||
Obligations of government-sponsored enterprises
|
$
|
-
|
$
|
71,314
|
$
|
-
|
$
|
71,314
|
||||||||
U.S. Treasury securities and obligations of U.S government instrumentalities
|
96,622
|
-
|
-
|
96,622
|
||||||||||||
Obligations of the Commonwealth of Puerto Rico and its instrumentalities
|
-
|
28,647
|
-
|
28,647
|
||||||||||||
Municipal securities
|
-
|
709,673
|
-
|
709,673
|
||||||||||||
Corporate bonds
|
-
|
218,269
|
-
|
218,269
|
||||||||||||
Residential agency mortgage-backed securities
|
-
|
822
|
-
|
822
|
||||||||||||
Collateralized mortgage obligations
|
-
|
19,241
|
-
|
19,241
|
||||||||||||
Total fixed maturities
|
96,622
|
1,047,966
|
-
|
1,144,588
|
||||||||||||
Equity securities - Mutual funds
|
230,610
|
64,624
|
14,869
|
310,103
|
||||||||||||
Total
|
$
|
327,232
|
$
|
1,112,590
|
$
|
14,869
|
$
|
1,454,691
|
December 31, 2015
|
||||||||||||||||
Level 1
|
Level 2
|
Level 3
|
Total
|
|||||||||||||
Securities available for sale:
|
||||||||||||||||
Fixed maturity securities
|
||||||||||||||||
Obligations of government-sponsored enterprises
|
-
|
116,240
|
-
|
116,240
|
||||||||||||
U.S. Treasury securities and obligations of U.S government instrumentalities
|
163,270
|
-
|
-
|
163,270
|
||||||||||||
Obligations of the Commonwealth of Puerto Rico and its instrumentalities
|
-
|
25,619
|
-
|
25,619
|
||||||||||||
Municipal securities
|
-
|
647,446
|
-
|
647,446
|
||||||||||||
Corporate bonds
|
-
|
157,408
|
-
|
157,408
|
||||||||||||
Residential agency mortgage-backed securities
|
-
|
937
|
-
|
937
|
||||||||||||
Collateralized mortgage obligations
|
-
|
22,725
|
-
|
22,725
|
||||||||||||
Total fixed maturities
|
163,270
|
970,375
|
-
|
1,133,645
|
||||||||||||
Equity securities - Mutual funds
|
167,082
|
22,031
|
7,958
|
197,071
|
||||||||||||
Total
|
$
|
330,352
|
$
|
992,406
|
$
|
7,958
|
$
|
1,330,716
|
Fair Value Measurements Using Significant
Unobservable Inputs (Level 3)
|
||||||||||||||||
Three months ended
June 30,
|
Six months ended
June 30,
|
|||||||||||||||
2016
|
2015
|
2016
|
2015
|
|||||||||||||
Beginning balance
|
$
|
6,997
|
$
|
10,191
|
$
|
7,958
|
$
|
13,349
|
||||||||
Realized gains
|
63
|
(700
|
)
|
214
|
1,412
|
|||||||||||
Unrealized in other accumulated comprehensive income
|
(321
|
)
|
(519
|
)
|
(969
|
)
|
(3,302
|
)
|
||||||||
Purchases
|
8,525
|
111
|
8,633
|
189
|
||||||||||||
Capital distributions
|
(395
|
)
|
-
|
(967
|
)
|
(2,565
|
)
|
|||||||||
Ending balance
|
$
|
14,869
|
$
|
9,083
|
$
|
14,869
|
$
|
9,083
|
(i) | Policy Loans |
(ii) | Policyholder Deposits |
(iii) | Long-term Borrowings |
June 30, 2016
|
||||||||||||||||||||
Carrying
Value
|
Fair Value
|
|||||||||||||||||||
Level 1
|
Level 2
|
Level 3
|
Total
|
|||||||||||||||||
Assets:
|
||||||||||||||||||||
Policy loans
|
$
|
8,301
|
$
|
-
|
$
|
8,301
|
$
|
-
|
$
|
8,301
|
||||||||||
Liabilities:
|
||||||||||||||||||||
Policyholder deposits
|
$
|
182,730
|
$
|
-
|
$
|
182,730
|
$
|
-
|
$
|
182,730
|
||||||||||
Long-term borrowings:
|
||||||||||||||||||||
Loans payable to bank - variable
|
12,007
|
-
|
12,007
|
-
|
12,007
|
|||||||||||||||
6.6% senior unsecured notes payable
|
24,000
|
-
|
19,200
|
-
|
19,200
|
|||||||||||||||
Total long-term borrowings
|
36,007
|
-
|
31,207
|
-
|
31,207
|
|||||||||||||||
Total liabilities
|
$
|
218,737
|
$
|
-
|
$
|
213,937
|
$
|
-
|
$
|
213,937
|
December 31, 2015
|
||||||||||||||||||||
Carrying
Value
|
Fair Value
|
|||||||||||||||||||
Level 1
|
Level 2
|
Level 3
|
Total
|
|||||||||||||||||
Assets:
|
||||||||||||||||||||
Policy loans
|
$
|
7,901
|
$
|
-
|
$
|
7,901
|
$
|
-
|
$
|
7,901
|
||||||||||
Liabilities:
|
||||||||||||||||||||
Policyholder deposits
|
$
|
179,287
|
$
|
-
|
$
|
179,287
|
$
|
-
|
$
|
179,287
|
||||||||||
Long-term borrowings:
|
||||||||||||||||||||
Loans payable to bank - variable
|
12,827
|
-
|
12,827
|
-
|
12,827
|
|||||||||||||||
6.6% senior unsecured notes payable
|
24,000
|
-
|
19,920
|
-
|
19,920
|
|||||||||||||||
Total long-term borrowings
|
36,827
|
-
|
32,747
|
-
|
32,747
|
|||||||||||||||
Total liabilities
|
$
|
216,114
|
$
|
-
|
$
|
212,034
|
$
|
-
|
$
|
212,034
|
(6) | Claim Liabilities |
Three months ended
June 30, |
Six months ended
June 30, |
|||||||||||||||
2016
|
2015
|
2016
|
2015
|
|||||||||||||
Claim liabilities at beginning of period
|
$
|
525,066
|
$
|
401,642
|
$
|
491,765
|
$
|
390,086
|
||||||||
Reinsurance recoverable on claim liabilities
|
(39,871
|
)
|
(39,958
|
)
|
(40,714
|
)
|
(40,635
|
)
|
||||||||
Net claim liabilities at beginning of period
|
485,195
|
361,684
|
451,051
|
349,451
|
||||||||||||
Incurred claims and loss-adjustment expenses:
|
||||||||||||||||
Current period insured events
|
622,859
|
628,900
|
1,244,339
|
1,080,137
|
||||||||||||
Prior period insured events
|
(7,414
|
)
|
3,783
|
(8,962
|
)
|
(21,901
|
)
|
|||||||||
Total
|
615,445
|
632,683
|
1,235,377
|
1,058,236
|
||||||||||||
Payments of losses and loss-adjustment expenses:
|
||||||||||||||||
Current period insured events
|
599,938
|
539,085
|
970,073
|
783,813
|
||||||||||||
Prior period insured events
|
56,947
|
32,252
|
272,600
|
200,844
|
||||||||||||
Total
|
656,885
|
571,337
|
1,242,673
|
984,657
|
||||||||||||
Net claim liabilities at end of period
|
443,755
|
423,030
|
443,755
|
423,030
|
||||||||||||
Reinsurance recoverable on claim liabilities
|
38,109
|
39,156
|
38,109
|
39,156
|
||||||||||||
Claim liabilities at end of period
|
$
|
481,864
|
$
|
462,186
|
$
|
481,864
|
$
|
462,186
|
(7) | Long-Term Borrowings |
(8) | Income Taxes |
(9) | Pension Plan |
Three months ended
June 30, |
Six months ended
June 30, |
|||||||||||||||
2016
|
2015
|
2016
|
2015
|
|||||||||||||
Components of net periodic benefit cost:
|
||||||||||||||||
Service cost
|
$
|
878
|
$
|
1,160
|
$
|
2,128
|
$
|
2,057
|
||||||||
Interest cost
|
1,939
|
2,322
|
4,701
|
4,222
|
||||||||||||
Expected return on assets
|
(2,054
|
)
|
(2,350
|
)
|
(4,980
|
)
|
(4,214
|
)
|
||||||||
Amortization of prior service benefit
|
(102
|
)
|
(126
|
)
|
(246
|
)
|
(226
|
)
|
||||||||
Amortization of actuarial loss
|
831
|
1,665
|
2,014
|
3,119
|
||||||||||||
Net periodic benefit cost
|
$
|
1,492
|
$
|
2,671
|
$
|
3,617
|
$
|
4,958
|
(10) | Stock Repurchase Program |
(11) | Comprehensive Income |
Net Unrealized Gain on Securities
|
||||||||||||||||
Three months ended
June 30,
|
Six months ended
June 30,
|
|||||||||||||||
2016
|
2015
|
2016
|
2015
|
|||||||||||||
Beginning Balance
|
$
|
82,055
|
$
|
103,261
|
$
|
62,478
|
$
|
101,467
|
||||||||
Other comprehensive income before reclassifications
|
18,193
|
(12,336
|
)
|
37,817
|
(11,504
|
)
|
||||||||||
Amounts reclassified from accumulated other comprehensive income
|
(2,363
|
)
|
(16,708
|
)
|
(2,410
|
)
|
(15,746
|
)
|
||||||||
Net current period change
|
15,830
|
(29,044
|
)
|
35,407
|
(27,250
|
)
|
||||||||||
Ending Balance
|
$
|
97,885
|
$
|
74,217
|
$
|
97,885
|
$
|
74,217
|
Liability for Pension Benefits
|
||||||||||||||||
Three months ended
June 30,
|
Six months ended
June 30,
|
|||||||||||||||
2016
|
2015
|
2016
|
2015
|
|||||||||||||
Beginning Balance
|
$
|
(36,221
|
)
|
$
|
(51,865
|
)
|
$
|
(36,855
|
)
|
$
|
(52,691
|
)
|
||||
Other comprehensive income before reclassifications
|
-
|
-
|
-
|
-
|
||||||||||||
Amounts reclassified from accumulated other comprehensive income
|
445
|
939
|
1,079
|
1,765
|
||||||||||||
Net current period change
|
445
|
939
|
1,079
|
1,765
|
||||||||||||
Ending Balance
|
$
|
(35,776
|
)
|
$
|
(50,926
|
)
|
$
|
(35,776
|
)
|
$
|
(50,926
|
)
|
Accumulated Other Comprehensive Income
|
||||||||||||||||
Three months ended
June 30,
|
Six months ended
June 30,
|
|||||||||||||||
2016
|
2015
|
2016
|
2015
|
|||||||||||||
Beginning Balance
|
$
|
45,834
|
$
|
51,396
|
$
|
25,623
|
$
|
48,776
|
||||||||
Other comprehensive income before reclassifications
|
18,193
|
(12,336
|
)
|
37,817
|
(11,504
|
)
|
||||||||||
Amounts reclassified from accumulated other comprehensive income
|
(1,918
|
)
|
(15,769
|
)
|
(1,331
|
)
|
(13,981
|
)
|
||||||||
Net current period change
|
16,275
|
(28,105
|
)
|
36,486
|
(25,485
|
)
|
||||||||||
Ending Balance
|
$
|
62,109
|
$
|
23,291
|
$
|
62,109
|
$
|
23,291
|
(12) | Share-Based Compensation |
(13) | Net Income Available to Stockholders and Net Income per Share |
Three months ended
June 30, |
Six months ended
June 30, |
|||||||||||||||
2016
|
2015
|
2016
|
2015
|
|||||||||||||
Numerator for earnings per share:
|
||||||||||||||||
Net income attributable to TSM available to stockholders
|
$
|
3,880
|
$
|
18,926
|
$
|
7,336
|
$
|
33,762
|
||||||||
Denominator for basic earnings per share:
|
||||||||||||||||
Weighted average of common shares
|
24,624,070
|
25,922,680
|
24,609,749
|
26,208,573
|
||||||||||||
Effect of dilutive securities
|
45,364
|
74,984
|
58,892
|
86,793
|
||||||||||||
Denominator for diluted earnings per share
|
24,669,434
|
25,997,664
|
24,668,641
|
26,295,366
|
||||||||||||
Basic net income per share attributable to TSM
|
$
|
0.16
|
$
|
0.73
|
$
|
0.30
|
$
|
1.29
|
||||||||
Diluted net income per share attributable to TSM
|
$
|
0.16
|
$
|
0.73
|
$
|
0.30
|
$
|
1.28
|
(14) | Contingencies |
(15) | Segment Information |
Three months ended
June 30, |
Six months ended
June 30, |
|||||||||||||||
2016
|
2015
|
2016
|
2015
|
|||||||||||||
Operating revenues:
|
||||||||||||||||
Managed Care:
|
||||||||||||||||
Premiums earned, net
|
$
|
668,932
|
$
|
695,517
|
$
|
1,347,312
|
$
|
1,167,684
|
||||||||
Administrative service fees
|
4,520
|
4,549
|
9,603
|
33,672
|
||||||||||||
Intersegment premiums/service fees
|
1,652
|
3,312
|
3,137
|
4,505
|
||||||||||||
Net investment income
|
4,107
|
2,719
|
7,587
|
5,717
|
||||||||||||
Total managed care
|
679,211
|
706,097
|
1,367,639
|
1,211,578
|
||||||||||||
Life Insurance:
|
||||||||||||||||
Premiums earned, net
|
38,591
|
36,245
|
77,557
|
74,025
|
||||||||||||
Intersegment premiums
|
202
|
70
|
339
|
131
|
||||||||||||
Net investment income
|
6,412
|
6,103
|
12,326
|
11,884
|
||||||||||||
Total life insurance
|
45,205
|
42,418
|
90,222
|
86,040
|
||||||||||||
Property and Casualty Insurance:
|
||||||||||||||||
Premiums earned, net
|
21,526
|
22,345
|
42,714
|
44,956
|
||||||||||||
Intersegment premiums
|
154
|
154
|
307
|
307
|
||||||||||||
Net investment income
|
2,325
|
2,131
|
4,254
|
4,221
|
||||||||||||
Total property and casualty insurance
|
24,005
|
24,630
|
47,275
|
49,484
|
||||||||||||
Other segments: *
|
||||||||||||||||
Intersegment service revenues
|
2,617
|
2,779
|
5,162
|
5,162
|
||||||||||||
Operating revenues from external sources
|
959
|
680
|
1,815
|
1,863
|
||||||||||||
Total other segments
|
3,576
|
3,459
|
6,977
|
7,025
|
||||||||||||
Total business segments
|
751,997
|
776,604
|
1,512,113
|
1,354,127
|
||||||||||||
TSM operating revenues from external sources
|
1
|
16
|
5
|
30
|
||||||||||||
Elimination of intersegment premiums/service fees
|
(2,008
|
)
|
(3,536
|
)
|
(3,783
|
)
|
(4,943
|
)
|
||||||||
Elimination of intersegment service revenues
|
2,518
|
(2,779
|
)
|
(27
|
)
|
(5,162
|
)
|
|||||||||
Other intersegment eliminations
|
(5,149
|
)
|
(10
|
)
|
(5,162
|
)
|
(5
|
)
|
||||||||
Consolidated operating revenues
|
$
|
747,359
|
$
|
770,295
|
$
|
1,503,146
|
$
|
1,344,047
|
* | Includes segments that are not required to be reported separately, primarily the data processing services organization and the health clinic. |
Three months ended
June 30, |
Six months ended
June 30, |
|||||||||||||||
2016
|
2015
|
2016
|
2015
|
|||||||||||||
Operating (loss) income:
|
||||||||||||||||
Managed care
|
$
|
(3,780
|
)
|
$
|
(2,515
|
)
|
$
|
(4,421
|
)
|
$
|
8,457
|
|||||
Life insurance
|
5,054
|
5,286
|
10,652
|
10,102
|
||||||||||||
Property and casualty insurance
|
3,388
|
2,454
|
5,499
|
3,960
|
||||||||||||
Other segments *
|
(182
|
)
|
(121
|
)
|
(361
|
)
|
(284
|
)
|
||||||||
Total business segments
|
4,480
|
5,104
|
11,369
|
22,235
|
||||||||||||
TSM operating revenues from external sources
|
1
|
16
|
5
|
30
|
||||||||||||
TSM unallocated operating expenses
|
(2,707
|
)
|
(1,937
|
)
|
(5,874
|
)
|
(7,540
|
)
|
||||||||
Elimination of TSM intersegment charges
|
2,386
|
2,390
|
4,773
|
4,795
|
||||||||||||
Consolidated operating income
|
4,160
|
5,573
|
10,273
|
19,520
|
||||||||||||
Consolidated net realized investment gains
|
1,520
|
10,607
|
1,578
|
16,820
|
||||||||||||
Consolidated interest expense
|
(1,954
|
)
|
(2,074
|
)
|
(3,836
|
)
|
(4,256
|
)
|
||||||||
Consolidated other income, net
|
3,859
|
1,083
|
4,734
|
2,842
|
||||||||||||
Consolidated income before taxes
|
$
|
7,585
|
$
|
15,189
|
$
|
12,749
|
$
|
34,926
|
||||||||
Depreciation and amortization expense:
|
||||||||||||||||
Managed care
|
$
|
2,839
|
$
|
3,281
|
$
|
5,773
|
$
|
6,760
|
||||||||
Life insurance
|
249
|
279
|
504
|
549
|
||||||||||||
Property and casualty insurance
|
150
|
88
|
311
|
190
|
||||||||||||
Other segments*
|
166
|
119
|
319
|
245
|
||||||||||||
Total business segments
|
3,404
|
3,767
|
6,907
|
7,744
|
||||||||||||
TSM depreciation expense
|
196
|
197
|
393
|
394
|
||||||||||||
Consolidated depreciation and amortization expense
|
$
|
3,600
|
$
|
3,964
|
$
|
7,300
|
$
|
8,138
|
* | Includes segments that are not required to be reported separately, primarily the data processing services organization and the health clinic. |
June 30,
2016 |
December 31,
2015 |
|||||||
Assets:
|
||||||||
Managed care
|
$
|
1,126,240
|
$
|
1,034,725
|
||||
Life insurance
|
820,789
|
770,721
|
||||||
Property and casualty insurance
|
364,565
|
350,514
|
||||||
Other segments *
|
26,091
|
25,629
|
||||||
Total business segments
|
2,337,685
|
2,181,589
|
||||||
Unallocated amounts related to TSM:
|
||||||||
Cash, cash equivalents, and investments
|
1,487
|
12,304
|
||||||
Property and equipment, net
|
22,859
|
23,219
|
||||||
Other assets
|
30,909
|
31,732
|
||||||
55,255
|
67,255
|
|||||||
Elimination entries-intersegment receivables and others
|
(77,646
|
)
|
(42,699
|
)
|
||||
Consolidated total assets
|
$
|
2,315,294
|
$
|
2,206,145
|
* | Includes segments that are not required to be reported separately, primarily the data processing services organization and the health clinic. |
(16) | Subsequent Events |
As of June 30,
|
||||||||
2016
|
2015
|
|||||||
Managed care enrollment:
|
||||||||
Commercial 1
|
528,902
|
561,440
|
||||||
Medicare
|
116,215
|
120,147
|
||||||
Medicaid
|
402,661
|
433,093
|
||||||
Total
|
1,047,778
|
1,114,680
|
||||||
Managed care enrollment by funding arrangement:
|
||||||||
Fully-insured
|
868,157
|
928,323
|
||||||
Self-insured
|
179,621
|
186,357
|
||||||
Total
|
1,047,778
|
1,114,680
|
(1) | Commercial membership includes corporate accounts, self-funded employers, individual accounts, Medicare Supplement, Federal government and local government employees. |
Three months ended
June 30, |
Six months ended
June 30, |
|||||||||||||||
(dollar amounts in millions)
|
2016
|
2015
|
2016
|
2015
|
||||||||||||
Revenues:
|
||||||||||||||||
Premiums earned, net
|
$
|
729.1
|
$
|
754.1
|
$
|
1,467.6
|
$
|
1,286.7
|
||||||||
Administrative service fees
|
4.5
|
4.6
|
9.6
|
33.7
|
||||||||||||
Net investment income
|
12.9
|
11.0
|
24.2
|
21.9
|
||||||||||||
Other operating revenues
|
0.9
|
0.6
|
1.7
|
1.7
|
||||||||||||
Total operating revenues
|
747.4
|
770.3
|
1,503.1
|
1,344.0
|
||||||||||||
Net realized investment gains
|
1.5
|
10.6
|
1.6
|
16.8
|
||||||||||||
Other income, net
|
3.8
|
1.1
|
4.7
|
2.9
|
||||||||||||
Total revenues
|
752.7
|
782.0
|
1,509.4
|
1,363.7
|
||||||||||||
Benefits and expenses:
|
||||||||||||||||
Claims incurred
|
622.1
|
637.9
|
1,248.8
|
1,070.3
|
||||||||||||
Operating expenses
|
121.1
|
126.8
|
244.1
|
254.2
|
||||||||||||
Total operating expenses
|
743.2
|
764.7
|
1,492.9
|
1,324.5
|
||||||||||||
Interest expense
|
1.9
|
2.1
|
3.8
|
4.3
|
||||||||||||
Total benefits and expenses
|
745.1
|
766.8
|
1,496.7
|
1,328.8
|
||||||||||||
Income before taxes
|
7.6
|
15.2
|
12.7
|
34.9
|
||||||||||||
Income tax expense (benefit)
|
3.7
|
(3.7
|
)
|
5.4
|
1.2
|
|||||||||||
Net income
|
3.9
|
18.9
|
7.3
|
33.7
|
||||||||||||
Less: net loss attributable to non-controlling interest
|
-
|
-
|
-
|
0.1
|
||||||||||||
Net income attributable to TSM
|
$
|
3.9
|
$
|
18.9
|
$
|
7.3
|
$
|
33.8
|
· | The Property and Casualty segment reassessed the tax rate used to measure several temporary differences; as a consequence such rate was increased from 20% to 39%, resulting in an increase to its deferred tax expense of approximately $2.6 million. |
· | During the 2015 period, the Company executed a Closing Agreement between TSM and its subsidiaries and the Puerto Rico Treasury Department in connection with a local law that provided a temporary preferential tax rate in capital asset transactions. These events allowed the Company to record a $3.1 million benefit in the 2015 period resulting from the enacted lower taxable rate and the reassessment of the realizability of some of its deferred taxes. |
· | The Property and Casualty segment reassessed the tax rate used to measure several temporary differences; as a consequence such rate was increased from 20% to 39%, resulting in an increase to its deferred tax expense of approximately $2.6 million. |
· | During the 2015 period, the Company executed a Closing Agreement between TSM and its subsidiaries and the Puerto Rico Treasury Department in connection with a local law that provided a temporary preferential tax rate in capital asset transactions. These events allowed the Company to record a $3.1 million benefit in the 2015 period resulting from the enacted lower taxable rate and the reassessment of the realizability of some of its deferred taxes. |
Three months ended
June 30, |
Six months ended
June 30, |
|||||||||||||||
(dollar amounts in millions)
|
2016
|
2015
|
2016
|
2015
|
||||||||||||
Operating revenues:
|
||||||||||||||||
Medical premiums earned, net:
|
||||||||||||||||
Commercial
|
$
|
215.0
|
$
|
211.6
|
$
|
430.5
|
$
|
424.1
|
||||||||
Medicare
|
273.1
|
278.6
|
534.0
|
538.6
|
||||||||||||
Medicaid
|
181.2
|
205.6
|
383.4
|
205.6
|
||||||||||||
Medical premiums earned, net
|
669.3
|
695.8
|
1,347.9
|
1,168.3
|
||||||||||||
Administrative service fees
|
5.8
|
7.6
|
12.1
|
37.6
|
||||||||||||
Net investment income
|
4.1
|
2.7
|
7.6
|
5.7
|
||||||||||||
Total operating revenues
|
679.2
|
706.1
|
1,367.6
|
1,211.6
|
||||||||||||
Medical operating costs:
|
||||||||||||||||
Medical claims incurred
|
590.2
|
608.4
|
1,186.5
|
1,008.5
|
||||||||||||
Medical operating expenses
|
92.8
|
100.2
|
185.5
|
194.6
|
||||||||||||
Total medical operating costs
|
683.0
|
708.6
|
1,372.0
|
1,203.1
|
||||||||||||
Medical operating (loss) income
|
$
|
(3.8
|
)
|
$
|
(2.5
|
)
|
$
|
(4.4
|
)
|
$
|
8.5
|
|||||
Additional data:
|
||||||||||||||||
Member months enrollment:
|
||||||||||||||||
Commercial:
|
||||||||||||||||
Fully-insured
|
1,063,422
|
1,125,363
|
2,159,704
|
2,269,092
|
||||||||||||
Self-funded
|
540,221
|
561,220
|
1,083,247
|
1,135,554
|
||||||||||||
Total Commercial member months
|
1,603,643
|
1,686,583
|
3,242,951
|
3,404,646
|
||||||||||||
Medicare member months
|
351,108
|
355,942
|
715,535
|
703,024
|
||||||||||||
Medicaid:
|
||||||||||||||||
Fully-insured
|
1,206,345
|
1,303,512
|
2,428,237
|
1,303,512
|
||||||||||||
Self-insured
|
-
|
-
|
-
|
4,229,082
|
||||||||||||
Total Medicaid member months
|
1,206,345
|
1,303,512
|
2,428,237
|
5,532,594
|
||||||||||||
Total member months
|
3,161,096
|
3,346,037
|
6,386,723
|
9,640,264
|
||||||||||||
Medical loss ratio
|
88.2
|
%
|
87.4
|
%
|
88.0
|
%
|
86.3
|
%
|
||||||||
Operating expense ratio
|
13.7
|
%
|
14.2
|
%
|
13.6
|
%
|
16.1
|
%
|
· | Medicaid premiums decreased by $24.4 million, or 11.9% primarily as the result of a decrease in member month enrollment by 97,167, or 7.5%, reflecting the population decline in Puerto Rico. This decrease also includes, as a reduction to Medicaid premiums, the accrual of $14.6 million of excess profit (return premiums) due to a better loss experience that resulted in profits over the allowable 2.5% margin threshold. |
· | Medicare premiums decrease of $5.5 million, or 2.0% primarily results from lower enrollment by 4,834 member month when compared to 2015 combined with a 2.5% average reduction in 2016 Medicare reimbursement rates. |
· | Commercial premiums increase of $3.4 million, or 1.6%, primarily results from the approximately 7% year over year increase in average premium rates, partially offset by a decrease in fully insured member month enrollment by 61,941, or 5.5%. |
· | The medical claims incurred of the Medicaid business decreased by $24.3 million during the 2016 period primarily reflecting a favorable prior period reserve development due to lower utilization trends and the previously described lower member month enrollment. The favorable prior period reserve developments was in part, responsible for generating a profit for this program in excess of the allowable 2.5% maximum margin which made it necessary for us to record the previously discussed return premium. The Medicaid MLR was 89.3%, 120 basis points lower than last year. |
· | The medical claims incurred of the Medicare business decreased by $5.0 million, or 2.1%, during the 2016 period reflecting the previously mentioned decrease in membership and lower benefits in the 2016 products as compared to 2015 as the result of the decrease in reimbursement rates. Adjusting for the effect of prior period reserve developments, and moving the mid-year and 2015 final risk score revenue adjustments to their corresponding periods, our Medicare MLR would have been approximately 88.7% this quarter, about 280 basis points higher than last year, mostly driven by increased Part B drug costs, mainly related to cancer and rheumatoid arthritis. |
· | The medical claims incurred of the Commercial business increased by $11.0 million, or 6.1%, during the 2016 period. The Commercial MLR was 89.2%, which is 380 basis points higher than the MLR for the prior year. These increases reflect the impact of unfavorable prior period reserve development. Excluding the effect of prior period reserve developments in 2016 and 2015, the MLR would have decreased by 100 basis points to 85.7%. |
· | Medical premiums generated by the Medicaid business increased by $177.8 million to $383.4 million during the six months ended June 30, 2016. This fluctuation is primarily the result of the change in the Medicaid service model, from an ASO agreement to a fully insured model effective April 1, 2015. This decrease also includes, as a reduction to Medicaid premiums, the accrual of $10.9 million of excess profit (return premiums) due to a better loss experience that resulted in profits over the allowable 2.5% margin threshold. |
· | Medical premiums generated by the Commercial business increased by $6.4 million, or 1.5%, to $430.5 million. This fluctuation is primarily the result of approximately 7% year over year increase in average premium rates, partially offset by a decrease in fully insured member month enrollment. |
· | Medical premiums generated by the Medicare business decreased by $4.6 million, or 0.9%, to $534.0 million. This fluctuation primarily results from lower risk score revenue as compared with 2015 and a reduction in 2016 Medicare reimbursement rates, offset in part by higher member month enrollment. |
· | The medical claims incurred of the Medicaid business increased by $157.9 million during the 2016 period reflecting the previously mentioned change in the Medicaid contract effective April 1, 2015. The Medicaid MLR was 89.7%, 80 basis points lower than last year, primarily reflecting lower utilization. |
· | The medical claims incurred of the Commercial business increased by $12.8 million, or 3.6%, during the 2016 period mostly reflecting the impact of prior period reserve development. The Commercial MLR was 86.0%, which is 170 basis points higher than the MLR for the prior year. Excluding the effect of prior period reserve developments in 2016 and 2015, the MLR would have decreased by 240 basis points, reflecting the continuity of our underwriting discipline and premium trends higher than claims trends. |
· | The medical claims incurred of the Medicare business increased by $7.3 million, or 1.6%, during the 2016 period and its MLR was 88.3%, which is 210 basis points higher than the MLR for the prior period. Adjusting for the effect of prior period reserve developments, and moving the 2015 final risk score revenue adjustment to its corresponding period, our Medicare MLR would have been 90.4%, about 270 basis points higher than last year. The higher MLR primarily reflects, a higher number of HRAs completed in 2016 compared to last year and higher Part B drug costs, mainly related to cancer and rheumatoid arthritis. |
Three months ended
June 30, |
Six months ended
June 30, |
|||||||||||||||
(dollar amounts in millions)
|
2016
|
2015
|
2016
|
2015
|
||||||||||||
Operating revenues:
|
||||||||||||||||
Premiums earned, net:
|
||||||||||||||||
Premiums earned
|
$
|
39.7
|
$
|
38.1
|
$
|
79.5
|
$
|
76.8
|
||||||||
Assumed earned premiums
|
1.2
|
0.6
|
2.7
|
2.2
|
||||||||||||
Ceded premiums earned
|
(2.1
|
)
|
(2.4
|
)
|
(4.3
|
)
|
(4.9
|
)
|
||||||||
Premiums earned, net
|
38.8
|
36.3
|
77.9
|
74.1
|
||||||||||||
Net investment income
|
6.4
|
6.1
|
12.3
|
11.9
|
||||||||||||
Total operating revenues
|
45.2
|
42.4
|
90.2
|
86.0
|
||||||||||||
Operating costs:
|
||||||||||||||||
Policy benefits and claims incurred
|
21.9
|
19.2
|
43.4
|
40.7
|
||||||||||||
Underwriting and other expenses
|
18.2
|
17.9
|
36.2
|
35.2
|
||||||||||||
Total operating costs
|
40.1
|
37.1
|
79.6
|
75.9
|
||||||||||||
Operating income
|
$
|
5.1
|
$
|
5.3
|
$
|
10.6
|
$
|
10.1
|
||||||||
Additional data:
|
||||||||||||||||
Loss ratio
|
56.4
|
%
|
52.9
|
%
|
55.7
|
%
|
54.9
|
%
|
||||||||
Operating expense ratio
|
46.9
|
%
|
49.3
|
%
|
46.5
|
%
|
47.5
|
%
|
Three months ended
June 30, |
Six months ended
June 30, |
|||||||||||||||
(Dollar amounts in millions)
|
2016
|
2015
|
2016
|
2015
|
||||||||||||
Operating revenues:
|
||||||||||||||||
Premiums earned, net:
|
||||||||||||||||
Premiums written
|
$
|
40.9
|
$
|
39.1
|
$
|
68.5
|
$
|
67.0
|
||||||||
Premiums ceded
|
(13.1
|
)
|
(12.5
|
)
|
(23.5
|
)
|
(23.3
|
)
|
||||||||
Change in unearned premiums
|
(6.1
|
)
|
(4.1
|
)
|
(2.0
|
)
|
1.6
|
|||||||||
Premiums earned, net
|
21.7
|
22.5
|
43.0
|
45.3
|
||||||||||||
Net investment income
|
2.3
|
2.1
|
4.3
|
4.2
|
||||||||||||
Total operating revenues
|
24.0
|
24.6
|
47.3
|
49.5
|
||||||||||||
Operating costs:
|
||||||||||||||||
Claims incurred
|
10.8
|
11.4
|
20.6
|
22.7
|
||||||||||||
Underwriting and other expenses
|
9.8
|
10.7
|
21.2
|
22.8
|
||||||||||||
Total operating costs
|
20.6
|
22.1
|
41.8
|
45.5
|
||||||||||||
Operating income
|
$
|
3.4
|
$
|
2.5
|
$
|
5.5
|
$
|
4.0
|
||||||||
Additional data:
|
||||||||||||||||
Loss ratio
|
49.8
|
%
|
50.7
|
%
|
47.9
|
%
|
50.1
|
%
|
||||||||
Operating expense ratio
|
45.2
|
%
|
47.6
|
%
|
49.3
|
%
|
50.3
|
%
|
||||||||
Combined ratio
|
95.0
|
%
|
98.3
|
%
|
97.2
|
%
|
100.4
|
%
|
Six months ended
June 30, |
||||||||
(dollar amounts in millions)
|
2016
|
2015
|
||||||
Sources (uses) of cash:
|
||||||||
Cash (used in) provided by operating activities
|
$
|
(10.6
|
)
|
$
|
76.7
|
|||
Net (purchases) proceeds of investment securities
|
(76.3
|
)
|
69.9
|
|||||
Net capital expenditures
|
(2.7
|
)
|
(3.0
|
)
|
||||
Payments of long-term borrowings
|
(0.8
|
)
|
(11.8
|
)
|
||||
Proceeds from policyholder deposits
|
7.9
|
4.5
|
||||||
Surrenders of policyholder deposits
|
(6.9
|
)
|
(6.3
|
)
|
||||
Repurchase and retirement of common stock
|
(14.6
|
)
|
(26.0
|
)
|
||||
Other
|
2.3
|
(1.5
|
)
|
|||||
Net (decrease) increase in cash and cash equivalents
|
$
|
(101.7
|
)
|
$
|
102.5
|
(Dollar amounts in millions, except per share data)
|
Total Number
of Shares
Purchased
|
Average
Price
Paid per
Share
|
Total Number of
Shares
Purchased as
Part of Publicly
Announced
Programs ¹
|
Approximate
Dollar Value of
Shares that May
Yet Be Purchased
Under the
Programs
|
||||||||||||
April 1, 2016 to April 30, 2016
|
-
|
$
|
-
|
-
|
$
|
13.3
|
||||||||||
May 1, 2016 to May 31, 2016
|
177,678
|
22.42
|
177,678
|
9.3
|
||||||||||||
June 1, 2016 to June 30, 2016
|
107,168
|
23.75
|
107,168
|
6.8
|
¹ | In November 2015 the Company's Board of Directors authorized a $25.0 million Share Repurchase Program of its Class B common stock. |
Exhibits
|
Description
|
11
|
Statement re computation of per share earnings; an exhibit describing the computation of the earnings per share for the three and six months ended June 30, 2016 and 2015 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.
|
Certification of the President and Chief Executive Officer required by Rule 13a-14(a)/15d-14(a).
|
|
Certification of the Executive Vice President and Chief Financial Officer required by Rule 13a-14(a)/15d-14(a).
|
|
Certification of the President and Chief Executive Officer required pursuant to 18 U.S.C Section 1350.
|
|
Certification of the Executive Vice President and Chief Financial Officer required pursuant to 18 U.S.C Section 1350.
|
* | Filed herein. |
Triple-S Management Corporation
|
|||||
Registrant | |||||
Date:
|
August 5, 2016
|
By:
|
/s/ Roberto García-Rodríguez
|
||
Roberto García-Rodríguez
|
|||||
President and Chief Executive Officer
|
|||||
Date:
|
August 5, 2016
|
By:
|
/s/ Juan J. Román-Jiménez
|
||
Juan J. Román-Jiménez
|
|||||
Executive Vice President and Chief Financial Officer
|