Triple-S Management Corporation Reports Results for Third Quarter 2013

SAN JUAN, Puerto Rico, Nov. 6, 2013 /PRNewswire/ -- Triple-S Management Corporation (NYSE: GTS), the leading managed care company in Puerto Rico, today announced consolidated revenues of $596.7 million and consolidated net income of $18.6 million, or $0.68 per diluted share, including a special distribution from the Puerto Rico Joint Underwriting Association of $12.8 million, net of tax.

September Quarter Consolidated Highlights

  • Total consolidated operating revenues were $582.9 million;
  • Consolidated operating income was $10.3 million;
  • Consolidated loss ratio was 83.3%;
  • Medical loss ratio (MLR) was 86.7%;
  • Managed Care member month enrollment fell 1.9%;
  • Medicare member month enrollment decreased 6.5%.

Ramon Ruiz-Comas, President and CEO of Triple-S Management Corporation commented, "Consistent with normal seasonal trends, the third quarter typically reflects the second highest utilization in any given year, and this year was no exception. The quarter was also impacted by the anticipated reduction in ASO fee revenue associated with the Medicaid (miSalud) contract extension effective July 1, 2013. However, the membership for the three new regions, also at this reduced fee, did not come on stream until October 1, 2013. Additionally, unfavorable prior period reserve developments on the Commercial side, and an unforeseen high volume of medical claims in the USVI market impacted the period's results. As we enter the fourth quarter, historically our best-performing due to lower utilization, and with full miSalud membership on stream, we expect our full-year pro-forma EPS to fall within the lower end of our guidance of $1.95-$2.05.

"The addition of the three new miSalud regions has proceeded smoothly, and our membership in this important program is now approximately 1.4 million across eight regions. Notably, Triple-S now services approximately 2.2 million people on the island. Achieving this record membership level is an important milestone for Triple-S Management as it reinforces our unwavering commitment to delivering quality healthcare in Puerto Rico.

"The Medicare Advantage business performance and trends are tracking consistent with our expectations. With open enrollment season now underway, we have a comprehensive product offering, under two well-established brands, that are competitive in the Puerto Rican marketplace," concluded Ruiz-Comas.

Selected Quarterly Details

  • Pro Forma Net Income Was $5.9 Million, or $0.22 Per Diluted Share. Weighted average shares outstanding were 27.4 million. This compares with pro forma net income of $11.7 million, or $0.41 per diluted share, in the corresponding quarter of 2012, based on weighted average shares outstanding of 28.5 million.
  • Managed Care Membership. Our Managed Care membership decreased by 1.4% year over year, reflecting lower Commercial and Medicare enrollment. Medicare membership decreased 6.6% year over year, to 114,783. Fully-insured and self-funded Commercial membership each declined 5.7%. Medicaid membership (all self-funded) increased 2.7%, to 896,452.
  • Consolidated Premiums Fell 3.1%, to $547.9 Million. The decrease was principally due to lower Managed Care premiums, resulting from lower Commercial and Medicare member month enrollment.
  • Administrative Service Fees Decreased 17.6%, to $22.4 Million. The lower service fee income reflects the decline in per-member, per-month fees agreed upon in the new miSalud contract that became effective July 1, 2013.
  • Other Income Increased $13.3 million, to $13.9 million. The increase in other income results from a $12.8 million, net of tax, special distribution received from the Joint Underwriting Association ("JUA") by our Property and Casualty segment.
  • Managed Care MLR Declined 300 Basis Points, to 86.7%. The MLR, adjusted to exclude prior-period reserve developments and risk score adjustments, was 40 basis points lower, primarily reflecting lower cost and utilization trends and improved drug costs in American Health, due to the new Pharmacy Benefit Manager ("PBM") contract and the positive impact of the 2013 product design, offset by higher utilization and cost trends in the Commercial sector, particularly in the U.S. Virgin Islands business.
  • Consolidated Loss Ratio Decreased 250 Basis Points, to 83.3%. The lower consolidated loss ratio mainly reflects the 300-basis-point improvement in the Managed Care MLR. The Property and Casualty and Life Insurance segments loss ratios increased by 530 and 20 basis points, respectively. The increased loss ratio within the Property and Casualty segment was mainly due to unusual liability and flood losses incurred during the period.
  • Consolidated Operating Expense Ratio Rose 280 Basis Points, to 20.4%. The higher consolidated operating expense ratio was largely due to the combination of decreased premiums and increased operating expenses, including special technology projects, Medicare revenue enhancement initiatives, and premium taxes that became effective July 1, 2013.
  • Consolidated Operating Income Declined 33.5%, to $10.3 Million. The decrease primarily reflects the effect of lower Managed Care operating revenues related to the reduction in administrative fees associated with the miSalud contract as of July 1, 2013 and increased operating expenses, partially offset by the lower Managed Care MLR.
  • Consolidated Operating Margin Was 1.8%. The 80-basis-point decrease in the consolidated operating margin is primarily the result of lower profitability in our Property and Casualty and Life Insurance segments.
  • Consolidated Effective Tax Rate Was 14.3%. The effective tax rate rose from 11.4% for the three months ended September 30, 2012 to 14.3% for the three months ended September 30, 2013.
           

Pro Forma Net Income

(Unaudited)

Three months ended

September 30,

 

Nine months ended

September 30,

(dollar amounts in millions)

2013

2012

 

2013

2012

Net income

 

$18.6

$11.7

 

$56.0

$36.3

Less pro forma adjustments:

         
 

Net realized investment gains (losses), net of tax

(0.1)

-

 

2.9

1.8

 

Special Distribution received Puerto Rico Joint Underwriting Association

12.8

-

 

12.8

-

 

Guaranty Fund assesment

-

-

 

(1.0)

-

 

Additional year-to-date current income tax expense after change

         
   

in enacted tax rate

 

-

 

(2.8)

-

 

Deferred tax benefit related to change in enacted tax rate

 

-

 

7.7

-

   

Pro forma net income

$ 5.9

$11.7

 

$36.4

$34.5

   

Diluted pro forma net income per share

$0.22

$0.41

 

$1.31

$1.21

 

Nine-Month Recap

For the nine months ended September 30, 2013, consolidated operating revenues decreased 2.5%, to $1.8 billion, primarily reflecting lower member month enrollment in the Medicare and Commercial sectors of the Managed Care segment, and the receipt of lower Medicare risk score adjustments in 2013 when compared with the prior year. Consolidated claims incurred for the nine-month period were $1.4 billion, down 6.1% year over year. The nine-month consolidated loss ratio decreased 320 basis points to 82.8% and the MLR fell 350 basis points, to 86.1%. This decline was driven by lower utilization and cost trends in the Medicare business, primarily at American Health. Consolidated operating expenses for the nine months ended September 30, 2013 were $351.3 million and the operating expense ratio was 20.3%. Pro forma net income for the nine-month period was $36.4 million, or $1.31 per diluted share, based on weighted average shares outstanding of 27.9 million, compared with $34.5 million, or $1.21 per diluted share, based on weighted average shares outstanding of 28.5 million at the same time last year.

Segment Performance

Triple-S Management operates in three segments: 1) Managed Care, 2) Life Insurance, and 3) Property and Casualty Insurance. Management evaluates performance based primarily on the operating revenues and operating income of each segment. Operating revenues include premiums earned, net, administrative service fees and net investment income. Operating costs include claims incurred and operating expenses. The Company calculates operating income or loss as operating revenues minus operating expenses. Operating margin is defined as operating income or loss divided by operating revenues. The adjusted medical loss ratio accounts for subsequent adjustments to estimates, such as MA premium adjustments and prior period reserve developments, and presents them in the corresponding period.

(Unaudited)

Three months ended September 30,

 

Nine months ended September 30,

(dollar amounts in millions)

2013

2012

Percentage

Change

 

2013

2012

Percentage

Change

Premiums earned, net:

             
 

Managed Care:

             
   

Commercial

$ 233.6

$ 240.5

(2.9%)

 

$ 705.9

$ 724.9

(2.6%)

   

Medicare

257.8

268.0

(3.8%)

 

778.7

807.9

(3.6%)

     

Total Managed Care

491.4

508.5

(3.4%)

 

1,484.6

1,532.8

(3.1%)

 

Life Insurance

32.4

31.8

1.9%

 

96.3

92.5

4.1%

 

Property and Casualty

24.7

25.9

(4.6%)

 

74.9

71.7

4.5%

 

Other

(0.6)

(0.6)

0.0%

 

(1.9)

(1.8)

5.6%

     

Consolidated premiums earned, net

 

$ 547.9

$ 565.6

(3.1%)

 

$ 1,653.9

$ 1,695.2

(2.4%)

Operating revenues:

             
 

Managed Care

$ 518.8

$ 540.8

(4.1%)

 

$ 1,577.7

$ 1,630.5

(3.2%)

 

Life Insurance

37.7

37.0

1.9%

 

112.6

107.8

4.5%

 

Property and Casualty

26.7

28.1

(5.0%)

 

81.0

78.4

3.3%

 

Other

(0.3)

(0.3)

0.0%

 

(0.9)

(1.4)

(35.7%)

     

Consolidated operating revenues

 

$ 582.9

$ 605.6

(3.7%)

 

$ 1,770.4

$ 1,815.3

(2.5%)

Operating income:

             
 

Managed Care

$ 7.3

$ 7.3

0.0%

 

$ 41.2

$ 33.3

23.7%

 

Life Insurance

3.8

4.1

(7.3%)

 

11.5

12.5

(8.0%)

 

Property and Casualty

0.4

1.9

(78.9%)

 

1.0

4.1

(75.6%)

 

Other

(1.2)

2.2

154.5%

 

(3.8)

(1.4)

171.4%

     

Consolidated operating income

 

$ 10.3

$ 15.5

(33.5%)

 

$ 49.9

$ 48.5

2.9%

Operating margin:

             
 

Managed Care

1.4%

1.3%

10 bp

 

2.6%

2.0%

60 bp

 

Life Insurance

10.1%

11.1%

-100 bp

 

10.2%

11.6%

-140 bp

 

Property and Casualty

1.5%

6.8%

-530 bp

 

1.2%

5.2%

-400 bp

 

Consolidated

1.8%

2.6%

-80 bp

 

2.8%

2.7%

10 bp

Depreciation and amortization expense

$ 5.6

$ 6.2

(9.7%)

 

$ 17.8

$ 18.0

(1.1%)

 

 

                 

Managed Care Additional Data

Three months ended

September 30,

 

Nine months ended

September 30,

(Unaudited)

2013

2012

 

2013

2012

Member months enrollment:

         
 

Commercial:

         
   

Fully-insured

1,372,671

1,448,985

 

4,155,820

4,375,260

   

Self-insured

641,177

676,007

 

1,964,761

2,007,635

     

Total Commercial

2,013,848

2,124,992

 

6,120,581

6,382,895

 

Medicare:

         
   

Medicare Advantage

319,434

342,180

 

957,848

1,011,150

   

Stand-alone PDP

24,492

25,502

 

72,930

76,197

     

Total Medicare

343,926

367,682

 

1,030,778

1,087,347

 

Medicaid -Self-insured

2,668,236

2,631,532

 

7,989,168

7,886,395

       

Total member months

5,026,010

5,124,206

 

15,140,527

15,356,637

Claim liabilities (in millions)

$ 282.9

$ 297.2

*

   

Days claim payable

59

60

*

   

Premium PMPM:

         
 

Managed Care

$ 286.26

$ 279.91

 

$ 286.24

$ 280.60

   

Commercial

170.18

165.98

 

169.86

165.68

   

Medicare

749.58

728.89

 

755.45

743.00

Medical loss ratio

86.7%

89.7%

 

86.1%

89.6%

 

Commercial

90.5%

89.8%

 

88.8%

89.2%

 

Medicare Advantage

82.8%

89.5%

 

83.4%

89.7%

 

Stand-alone PDP

94.9%

75.9%

 

88.4%

83.8%

Adjusted medical loss ratio

87.7%

88.1%

 

86.7%

85.7%

 

Commercial

89.7%

87.5%

 

88.8%

87.9%

 

Medicare Advantage

85.6%

88.8%

 

84.6%

89.0%

 

Stand-alone PDP

94.0%

71.7%

 

88.1%

80.1%

Operating expense ratio:

         
 

Consolidated

20.4%

17.6%

 

20.3%

17.4%

 

Managed Care

16.6%

14.4%

 

16.5%

13.8%

* Information provided as of December 31, 2012.

       

 

 

 

Managed Care Membership by Segment

As of September 30,

 

2013

2012

Members:

   
 

Commercial:

   
   

Fully-insured

455,540

483,103

   

Self-insured

212,747

225,540

     

Total Commercial

668,287

708,643

 

Medicare:

   
   

Medicare Advantage

106,596

114,419

   

Stand-alone PDP

8,187

8,506

     

Total Medicare

114,783

122,925

 

Medicaid -Self-insured

896,452

872,496

 

Total members

 

1,679,522

1,704,064

 

2013 Guidance

 

2013 Range

Medical enrollment fully-insured

 

(member months)

6.8 - 7.2 million

   

Medical enrollment self-insured

 

(member months)

14.6 – 15.0 million

   

Consolidated operating revenues

 

(in billions)

$2.28 - $2.34

   

Consolidated loss ratio

82.0% - 83.0%

   

Medical loss ratio

85.5% - 86.5%

   

Consolidated operating expense ratio

19.8% - 20.6%

   

Consolidated operating income (in millions)

$76.6 - $86.3

   

Pro forma earnings per share

$1.95 - $2.05

   

Weighted average of diluted shares

 

outstanding (in millions)

27.8

   

Effective tax rate

17.3% - 18.3%

2013 Investor Day Information

In conjunction with our six-year anniversary as a public company, we are hosting an Investor Day on December 6, 2013 at the New York Stock Exchange, 11 Wall Street, NYC, commencing at 12:00 pm EST. Several of our key executives will discuss their business segments and the various future growth opportunities for Triple-S. In order to attend, an RSVP is required to: Lisa Wilson, In-Site Communications, Inc. via phone at 212-452-2793 or via email at lwilson@insitecony.com.

Conference Call and Webcast

Management will host a conference call and webcast on November 6, 2013 at 8:00 a.m., Eastern Time to discuss its financial results for the three months ended September 30, 2013. To participate, callers within the U.S. and Canada should dial 1-877-941-8609, and international callers should dial 1-480-629-9692 about five minutes before the presentation.

To listen to the webcast, participants should visit the "Investor Relations" section of the Company's Web site at www.triplesmanagement.com several minutes before the event is broadcast and follow the instructions provided to ensure they have the necessary audio application downloaded and installed. This program is provided at no charge to the user. An archived version of the call, also located on the "Investor Relations" section of Triple-S Management's Web site, will be available about two hours after the call ends and for at least the following two weeks. This news release, along with other information relating to the call, will be available on the "Investor Relations" section of the Web site.

About Triple-S Management Corporation

Triple-S Management Corporation is an independent licensee of the Blue Cross Blue Shield Association. It is the leading player in the managed care industry in Puerto Rico. Triple-S Management also has the exclusive right to use the Blue Cross Blue Shield name and mark throughout Puerto Rico and the U.S. Virgin Islands. With more than 50 years of experience in the industry, Triple-S Management offers a broad portfolio of managed care and related products in the Commercial and Medicare Advantage markets under the Blue Cross Blue Shield marks. In addition to its managed care business, Triple-S Management provides non-Blue Cross Blue Shield branded life and property and casualty insurance in Puerto Rico.

For more information about Triple-S Management, visit www.triplesmanagement.com or contact kwaller@allwayscommunicate.com.

Forward-Looking Statements

This document contains forward-looking statements, as defined in the Private Securities Litigation Reform Act of 1995. Forward-looking statements include information about possible or assumed future sales, results of operations, developments, regulatory approvals or other circumstances. Sentences that include "believe", "expect", "plan", "intend", "estimate", "anticipate", "project", "may", "will", "shall", "should" and similar expressions, whether in the positive or negative, are intended to identify forward-looking statements.

All forward-looking statements in this news release reflect management's current views about future events and are based on assumptions and subject to risks and uncertainties. Consequently, actual results may differ materially from those expressed here as a result of various factors, including all the risks discussed and identified in public filings with the U.S. Securities and Exchange Commission (SEC).

In addition, the Company operates in a highly competitive, constantly changing environment, influenced by very large organizations that have resulted from business combinations, aggressive marketing and pricing practices of competitors, and regulatory oversight. The following factors, if markedly different from the Company's planning assumptions (either individually or in combination), could cause Triple-S Management's results to differ materially from those expressed in any forward-looking statements shared here:

  • Trends in health care costs and utilization rates
  • Ability to secure sufficient premium rate increases
  • Competitor pricing below market trends of increasing costs
  • Re-estimates of policy and contract liabilities
  • Changes in government laws and regulations of managed care, life insurance or property and casualty insurance
  • Significant acquisitions or divestitures by major competitors
  • Introduction and use of new prescription drugs and technologies
  • A downgrade in the Company's financial strength ratings
  • Litigation or legislation targeted at managed care, life insurance or property and casualty insurance companies
  • Ability to contract with providers consistent with past practice
  • Ability to successfully implement the Company's disease management, utilization management and Star ratings programs
  • Ability to maintain Federal Employer, Medicare and Medicaid contracts
  • Volatility in the securities markets and investment losses and defaults
  • General economic downturns, major disasters, and epidemics

This list is not exhaustive. Management believes the forward-looking statements in this release are reasonable. However, there is no assurance that the actions, events or results anticipated by the forward-looking statements will occur or, if any of them do, what impact they will have on the Company's results of operations or financial condition. In view of these uncertainties, investors should not place undue reliance on any forward-looking statements, which are based on current expectations. In addition, forward-looking statements are based on information available the day they are made, and (other than as required by applicable law, including the securities laws of the United States) the Company does not intend to update or revise any of them in light of new information or future events.

Readers are advised to carefully review and consider the various disclosures in the Company's SEC reports.

-FINANCIAL TABLES ATTACHED-

 

Condensed Consolidated Balance Sheets

(Dollar amounts in thousands, except per share data)

 
 
 
   

Unaudited
September 30,
2013

 

December 31,
2012

Assets

           
             

Investments

 

$

1,310,998

 

$

1,280,644

Cash and cash equivalents

   

81,764

   

89,564

Premium and other receivables, net

   

285,052

   

292,197

Deferred policy acquisition costs and value of business acquired

   

171,760

   

168,657

Property and equipment, net

   

90,087

   

92,423

Other assets

   

135,861

   

135,859

         
 

Total assets

 

$

2,075,522

 

$

2,059,344

         
             

Liabilities and Stockholders' Equity

           
             

Policy liabilities and accruals

 

$

925,489

 

$

922,393

Accounts payable and accrued liabilities

   

281,560

   

243,533

Short-term borrowings

   

13,410

   

30,000

Long-term borrowings

   

89,796

   

101,271

         
 

Total liabilities

   

1,310,255

   

1,297,197

         

Stockholders' equity:

           
 

Common stock

   

27,468

   

28,365

 

Other stockholders' equity

   

737,715

   

733,542

         
 

Total Triple-S Management Corporation stockholders' equity

     

765,183

   

761,907

             

Non-controlling interest in consolidated subsidiary

   

84

   

240

             

Total stockholders' equity

   

765,267

   

762,147

             

Total liabilities and stockholders' equity

 

$

2,075,522

 

$

2,059,344

 

 

Condensed Consolidated Statements of Earnings

(Dollar amounts in thousands, except per share data)

                                 
                                 
           

For the Three Months Ended

 

For the Nine Months Ended

           

September 30,

 

September 30,

           

Unaudited
2013

 

Unaudited
2012

 

Unaudited
2013

 

Unaudited
2012

Revenues:

                     
 

Premiums earned, net

$

547,874

 

$

565,607

 

$

1,653,870

 

$

1,695,157

 

Administrative service fees

 

22,450

   

27,181

   

78,103

   

82,473

 

Net investment income

 

11,363

   

11,595

   

34,749

   

34,349

 

Other operating revenues

 

1,239

   

1,206

   

3,638

   

3,358

                         
   

Total operating revenues

 

582,926

   

605,589

   

1,770,360

   

1,815,337

                                 
 

Net realized investment gains (losses)

 

(144)

   

21

   

3,405

   

2,157

 

Other income, net

 

13,931

   

598

   

14,778

   

1,514

                         
   

Total revenues

 

596,713

   

606,208

   

1,788,543

   

1,819,008

                         
                                 

Benefits and expenses:

                     
 

Claims incurred

 

456,432

   

485,495

   

1,369,250

   

1,457,388

 

Operating expenses

 

116,156

   

104,604

   

351,246

   

309,378

                         
   

Total operating costs

 

572,588

   

590,099

   

1,720,496

   

1,766,766

                                 
 

Interest expense

 

2,379

   

2,956

   

7,189

   

8,181

                         
   

Total benefits and expenses

 

574,967

   

593,055

   

1,727,685

   

1,774,947

                         
   

Income before taxes

 

21,746

   

13,153

   

60,858

   

44,061

                         

Income tax expense

 

3,142

   

1,470

   

4,993

   

7,862

                         

Net income

 

18,604

   

11,683

   

55,865

   

36,199

                         
 

Less: Net loss attributable to the non-controlling interest

 

37

   

32

   

156

   

65

                         

Net income attributable to TSM

$

18,641

 

$

11,715

 

$

56,021

 

$

36,264

                                 

Earnings per share attributable to TSM:

                     
                                 

Basic net income per share

$

0.68

 

$

0.41

 

$

2.01

 

$

1.28

Diluted earnings per share

$

0.68

 

$

0.41

 

$

2.01

 

$

1.27

 

 

Condensed Consolidated Statements of Cash Flows

(Dollar amounts in thousands, except per share data)

 
 
 

For the Nine Months Ended

 

September 30,

 

Unaudited
2013

 

Unaudited
2012

           

Net cash provided by operating activities

$

102,075

 

$

112,094

       

Cash flows from investing activities:

         
 

Proceeds from investments sold or matured:

         
   

Securities available for sale:

         
     

Fixed maturities sold

 

86,168

   

67,943

     

Fixed maturities matured/called

 

80,657

   

115,649

     

Equity securities sold

 

93,504

   

50,016

   

Securities held to maturity:

         
     

Fixed maturities matured/called

 

1,127

   

11,080

 

Acquisition of investments:

         
   

Securities available for sale:

         
     

Fixed maturities

 

(205,372)

   

(278,533)

     

Equity securities

 

(132,109)

   

(78,135)

   

Securities held to maturity:

         
     

Fixed maturities

 

(1,011)

   

(1,067)

   

Other investments

 

(823)

   

18

 

Net inflows (outflows) from policy loans

 

(209)

   

84

 

Acquisition of business, net of cash acquired of $816 in the

         
 

 

nine months ended September 30, 2012

 

-

   

(2,685)

 

Net capital expenditures

 

(8,934)

   

(8,756)

         
       

Net cash used in investing activities

   

(87,002)

   

(124,386)

         

Cash flows from financing activities:

           
 

Change in outstanding checks in excess of bank balances

 

22,809

   

(3,332)

 

Net change in short-term borrowings

 

(16,590)

   

11,200

 

Repayments of long-term borrowings

 

(11,475)

   

(26,464)

 

Repurchase and retirement of common stock

 

(18,250)

   

(637)

 

Proceeds from exercise of stock options

 

-

   

316

 

Proceeds from policyholder deposits

 

8,112

   

32,946

 

Surrenders of policyholder deposits

 

(7,479)

   

(4,821)

         
       

Net cash provided by financing activities

   

(22,873)

   

9,208

         
       

Net (decrease) increase in cash and cash equivalents

   

(7,800)

   

(3,084)

             

Cash and cash equivalents, beginning of period

   

89,564

   

71,834

         

Cash and cash equivalents, end of period

 

$

81,764

 

$

68,750

 

 

SOURCE Triple-S Management Corporation



RELATED LINKS
http://www.triplesmanagement.com

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