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Triple-s Management Corp

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FY2018 Annual Report · Triple-s Management Corp
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Special Note Regarding Forward-Looking Statements 

This Annual Report contains forward-looking statements, as such term is defined in the Private 
Securities Litigation Reform Act of 1995.  Forward-looking statements are statements that include 
information  about  possible  or  assumed  future  sales,  results  of  operations,  developments, 
regulatory approvals or other circumstances.  Statements that use the terms ‘‘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  Annual  Report  reflect  our  current  views  about  future 
events  and  are  based  on  assumptions  and  subject  to  risks  and  uncertainties.    Consequently, 
actual results may differ materially from those anticipated in these forward-looking statements as 
a result of various factors.  

influenced  by  very 

In  addition,  we  operate  in  a  highly  competitive,  constantly  changing  environment  that  is 
significantly 
that  have  resulted  from  business 
combinations,  aggressive  marketing  and  pricing  practices  of  competitors  and  regulatory 
oversight.  The following list is a summary of factors, the results of which, either individually or in 
combination,  if  markedly  different  from  our  planning  assumptions,  could  cause  our  business 
results  of  operations,  financial  condition,  cash  flow,  or  prospect,  to  be  materially  adversely 
affected from those expressed in any forward-looking statements contained in this Annual Report:  

large  organizations 

• 
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 our policy and contract liabilities; 
changes in government regulation 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 our financial strength ratings; 
• 

litigation  or  legislation  targeted  at  managed  care,  life  insurance  or  property  and  casualty 
insurance companies; 

•  ability to contract with providers and government agencies consistent with past practice; 
•  ability  to  successfully  implement  our  disease  management  and  utilization  management 

programs; 
volatility in the securities markets and investment losses and defaults; and 

• 
•  general economic downturns, major disasters and epidemics. 

The foregoing list should not be construed to be exhaustive.  We believe the forward-looking 
statements in this Annual Report 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 our results of operations or financial condition.  In view of these 
uncertainties, you should not place undue reliance on any forward-looking statements, which are 
based on our current expectations at the time the statements are made.  Further, forward-looking 
statements speak only as of the date they are made, and, other than as required by applicable 
law, including the securities laws of the United States, we do not intend to update or revise any 
of them in light of new information or future events. 

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2018 Financial Information 

 
 
 
 
 
  
 
 
 
 
 
 
 
 
 
 
 
Financial Information 2018 
Management’s Discussion and Analysis of Financial Condition 
And Results of Operations 

Quantitative and Qualitative Disclosures About Market Risk 

Consolidated Financial Statements 2018, 2017, and 2016 

Management’s Report on Internal Control Over Financial Reporting 

Reports of Independent Registered Public Accounting Firm 

Consolidated Balance Sheets 

Consolidated Statements of Earnings 

Consolidated Statements of Comprehensive Income 

Consolidated Statements of Stockholders’ Equity 

Consolidated Statements of Cash Flows 

Notes to Consolidated Financial Statements 

1 

28 

32 

33 

34 

36 

37 

38 

39 

40 

42

 
 
 
 
 
 
 
 
 
 
 
 
 
 
Management’s Discussion and Analysis of Financial Condition and Results of Operations 

This  financial  discussion  contains  an  analysis  of  our  consolidated  financial  position  and  financial 
performance as of December 31, 2018 and 2017, and consolidated results of operations for 2018, 2017 
and 2016.  References to the terms "we", "our" or "us" used throughout this Management's Discussion and 
Analysis of Financial Condition and Results of Operations (“MD&A”), refer to TSM and unless the context 
otherwise requires, its direct and indirect subsidiaries.  This analysis should be read in its entirety and in 
conjunction with the consolidated financial statements, notes and tables included elsewhere in this Annual 
Report on Form 10-K. 

Overview 

We are one of the most significant players in the managed care industry in Puerto Rico and have 60 
years of experience in this industry.  We offer a broad portfolio of managed care and related products in 
the Commercial, Medicare, and the Government of Puerto Rico health insurance plan (similar to Medicaid) 
(“Medicaid”  or  “the  Government  health  plan”)  markets.    In  the  Commercial  market  we  offer  products  to 
corporate accounts, U.S. federal government employees, local government employees, individual accounts 
and  Medicare  Supplement.    We  market  our  managed  care  products  through  an  extensive  network  of 
independent agents and brokers located throughout Puerto Rico, as well as an internal salaried sales force.  
Medicaid is funded by the Government of Puerto Rico and the U.S. Government. 

We have the exclusive right to use the BCBS name and mark throughout Puerto Rico, the U.S. Virgin 
Islands,  Costa  Rica,  the  British  Virgin  Islands  and  Anguilla.    As  of  December  31,  2018  we  serve 
approximately 876,000 members across all regions of Puerto Rico.  For the  years ended December 31, 
2018  and  2017  respectively,  our  Managed  Care  segment  represented  approximately  92%  of  our  total 
consolidated premiums earned, net.  We also participate in the life and property and casualty insurance 
markets in Puerto Rico. 

We participate in the managed care market through our subsidiaries, TSS, TSB and TSA.  TSS, TSA, 

and TSB are BCBSA licensees. 

We participate in the life insurance market through our subsidiary, TSV, and in the property and casualty 

insurance market through our subsidiary, TSP. 

The  Commissioner  of  Insurance  of  the  Government  of  Puerto  recognizes  only  statutory  accounting 
practices  for  determining  and  reporting  the  financial  condition  and  results  of  operations  of  an  insurance 
company, for determining its solvency under the Puerto Rico insurance laws, and for determining whether 
its financial condition warrants the payment of a dividend to its stockholders.  No consideration is given by 
the Commissioner of Insurance of Puerto Rico to financial statements prepared in accordance with U.S. 
generally accepted accounting principles (“GAAP”) in making such determinations.  See Note 25, Statutory 
Accounting, of the Notes to Consolidated Financial Statements, included in this Annual Report. 

2018 Consolidated Highlights 

Key developments in our business during 2018 are described below: 

•  Consolidated premiums earned, net increased 4.0% year over year, to $2.9 billion, primarily reflecting 

higher Managed Care premiums; 

•  Managed Care premiums increased 3.8% when compared to last year, primarily reflecting growth in 
Medicare  premiums following  the  Company’s  achievement  of  a  four-star  rated  Medicare  Advantage 
HMO  contract  this  year,  resulting  in  a  5%  bonus  applied  to  the  benchmark  used  in  the  premium 
calculation,  as  well  as  an  increase  in  the  2018  Medicare  reimbursement  rates.    This  increase  was 
partially offset by lower membership.  

•  Consolidated  claims  for  the  year  were  $2.5 billion,  up  7.4%  over  last  year,  primarily  reflecting  the 
$128.7 million  unfavorable  prior  period  reserve  development  in  the  Property  and  Casualty  segment 
related to Hurricane Maria losses.  Hurricane Maria was a category 4 hurricane that impacted Puerto 
Rico in September 2017.  In addition, in 2017 the Managed Care segment experienced significantly 

1 

 
 
lower utilization in the aftermath of Hurricanes Irma and Maria.  The consolidated loss ratio was up 280 
basis points, to 86.0%, and the MLR decreased 110 basis points, to 84.5%.   

•  Consolidated operating expenses for the year were $554.7 million and the operating expense ratio was 

18.8%. 

•  Net loss for the year was $63.3 million, a decrease from a net income of $54.5 million for the prior year, 
primarily  reflecting  the  unfavorable  prior  period  reserve  development  in  the  Property  and  Casualty 
segment related to the aforementioned hurricanes, the lower Managed Care utilization experienced in 
2017  due  to  the  aftermath  of  the  hurricanes,  and  the  impact  of  the  net  unrealized  losses  on  equity 
investments.  The unrealized loss on equity investments is due to the implementation effective January 
1,  2018  of  new  accounting  guidance  that  requires  the  change  in  unrealized  gain  (loss)  of  equity 
investments, previously recognized through comprehensive income, to be recorded through earnings. 

Overview details 

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 presented in this 
Annual Report on Form 10-K 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: 

Years ended December 31,
2017

2018

2016

$ 

2,689.1
168.6
83.5
(2.6)
2,938.6

$ 

$ 

2,590.0
161.8
77.2
(2.1)
2,826.9

$ 

$ 

2,648.5
156.9
87.9
(2.7)
2,890.6

$ 

$     

$     

19.1
(4.4)
14.7

$     

$     

21.6
(5.1)
16.5

$     

$     

22.4
(4.5)
17.9

$     

$     

$    

26.5
19.9
(110.1)
2.0
(61.3)

55.0
19.4
(6.0)
-
68.4

(36.8)
21.5
12.1
(2.0)
(5.2)

$    

$     

$      

(Dollar amounts in millions)

Premiums earned, net:

Managed care
Life insurance
Property and casualty insurance
Intersegment premiums earned

Consolidated premiums earned, net

Administrative service fees:

Managed care
Intersegment administrative service fees

Consolidated administrative service fees

Operating income (loss):

Managed care
Life insurance
Property and casualty insurance
Intersegment and other

Consolidated operating (loss) income

2 

 
 
 
 
     
     
     
       
       
       
        
        
        
        
        
        
       
       
       
    
        
       
         
         
        
Revenue 

General.    Our revenue consists primarily of (i) premium revenue generated from our Managed Care 
segment,  (ii) administrative  service  fees  received  for  services  provided  to  self-insured  employers, 
(iii) premiums we generate from our Life and Property and Casualty segments, and (iv) investment income. 

Premium Revenue.    Our revenue primarily consists of premiums earned from the sale of managed 
care  products  to  the  Commercial,  Medicare  Advantage  and  Medicaid  sectors.    We  receive  a  monthly 
payment  from  or  on  behalf  of  each member  enrolled  in  our  managed  care  plans  (excluding  ASO).   We 
recognize all premium revenue in our Managed Care segment during the month in which we are obligated 
to provide services to an enrolled member.  Premiums we receive in advance of that date are recorded as 
unearned premiums.  

Premiums are set prospectively, meaning that a fixed premium rate is determined at the beginning of 
each  contract  year  and  revised  at  renewal.    We  renegotiate  the  premiums  of  different  groups  as  their 
existing annual contracts become due.  Our Medicare Advantage contracts entitle us to premium payments 
from CMS on behalf of each Medicare beneficiary enrolled in our plans, generally on a per member per 
month (“PMPM”) basis.  We submit rate proposals to CMS in June for each Medicare Advantage product 
that will be offered beginning January 1 of the subsequent year in accordance with the competitive bidding 
process under the MMA.  Retroactive rate adjustments are made periodically with respect to our Medicare 
Advantage plans based on the aggregate health status and risk scores of our plan participants.  Premium 
rates for the Medicaid business are based on a bid contract with ASES and are revised each year, at which 
time rates are fixed for the plan year. 

Premiums  on  traditional  life  insurance  policies  are  reported  as  earned  when  due.    Premiums  on 
accident and health and other short-term contracts are recognized as earned, primarily on a pro rata basis 
over the contract period.  Premiums on credit life policies are recognized as earned in proportion to the 
amounts of insurance in force.  Group insurance premiums are billed one month in advance and a grace 
period of one month is provided for premium payment.  If the insured fails to pay within the one-month grace 
period, we may cancel the policy.  We recognize premiums on property and casualty contracts as earned 
on a pro rata basis over the policy term.  Property and casualty policies are subscribed through general 
agencies,  which  bill  policy  premiums  to  their  clients  in  advance  or,  in  the  case  of  new  business,  at  the 
inception  date  and  remit  collections  to  us,  net  of  commissions.    The  portion  of  premiums  related  to  the 
period prior to the end of coverage is recorded in the consolidated balance sheet as unearned premiums 
and is transferred to premium revenue as earned.  

Administrative Service Fees.    Administrative service fees include amounts paid to us for administrative 
services  provided  to  self-insured  contracts.    We  provide  a  range  of  customer  services  pursuant  to  our 
administrative  services  only  (“ASO”)  contracts,  including  claims  administration,  billing,  access  to  our 
provider networks and membership services.  Administrative service fees are recognized in the month in 
which services are provided.   

Investment  Income.    Investment  income  consists  of  interest  and  dividend  income  from  investment 
securities. See Note 5, Net Investment Income, of the Notes to Consolidated Financial Statements, included 
in this Annual Report. 

Expenses 

Claims Incurred.    Our largest expense is the Managed Care segment’s medical claims incurred, or 
the cost of medical services we arrange for our members.  Medical claims incurred include the payment of 
benefits  and  losses,  mostly  to  physicians,  hospitals,  pharmacies,  and  other  service  providers,  and  to 
policyholders.  We generally pay our providers on one of three forms: (1) fee-for-service contracts based 
on  negotiated  fee  schedules;  (2) capitation  arrangements,  generally  on  a  fixed  PMPM  payment  basis, 
whereby  the  provider  generally  assumes  some  of  the  medical  expense  risk;  and  (3) risk-sharing 
arrangements, whereby we advance a PMPM payment and share the risk of certain medical costs of our 
members with the provider based on actual experience as measured against pre-determined sharing ratios.  
Claims  incurred  also  include  claims  incurred  in  our  Life  and  Property  and  Casualty  segments.    Each 
segment’s  results  of  operations  depend  to  a  significant  extent  on  our  ability  to  accurately  predict  and 
effectively manage claims and losses.  A portion of the claims incurred for each period consists of claims 

3 

 
reported but not paid during the period, as well as a management and actuarial estimate of claims incurred 
but not reported during the period.  

The MLR, which is calculated by dividing managed care claims incurred by managed care premiums 
earned, net is one of our primary management tools for measuring these costs  and their  impact on our 
profitability.  The MLR is affected by the cost and utilization of services.  The cost of services is affected by 
many factors, in particular our ability to negotiate competitive rates with our providers.  The cost of services 
is also influenced by inflation and new medical discoveries, including new prescription drugs, therapies and 
diagnostic procedures.  Utilization rates, which reflect the extent to which beneficiaries utilize healthcare 
services, significantly influence our medical costs.  The level of utilization of services depends in large part 
on the age, health and lifestyle of our members, among other factors.  As the MLR is the ratio of claims 
incurred to premiums earned, net, it is affected not only by our ability to contain cost trends but also by our 
ability to increase premium rates to levels consistent with or above medical cost trends.  We use MLRs 
both to monitor our management of healthcare costs and to make various business decisions, including 
what plans or benefits to offer and our selection of healthcare providers.  

Operating  Expenses.    Operating  expenses  include  commissions  to  external  brokers,  general  and 
administrative expenses, cost containment expenses such as case and disease management programs, 
and  depreciation  and  amortization.    The  operating  expense  ratio  is  calculated  by  dividing  operating 
expenses by premiums earned, net plus administrative service fees.  A significant portion of our operating 
expenses are fixed costs.  Accordingly, it is important that we maintain certain level of volume of business 
in order to compensate for the fixed costs.  Significant changes in our volume of business will affect our 
operating expense ratio and results of operations.  We also have variable costs, which vary in proportion 
to changes in volume of business. 

Membership 

Our results of operations depend in large part on our ability to maintain or grow our membership.  In 
addition  to  driving  revenues,  membership  growth  is  necessary  to  successfully  introduce  new  products, 
maintain an extensive network of providers and achieve economies of scale.  Our ability to maintain or grow 
our membership is affected principally by the competitive environment, the economy, and general market 
conditions. 

The following table sets forth selected membership data as of the dates set forth below: 

Commercial (1)
Medicare
Medicaid 
Total

As of December 31,

2018

2017

2016

449,047
108,605
318,616
876,268

475,026
118,451
384,462
977,939

509,157
110,297
397,918
1,017,372

(1)  Commercial  membership  includes  corporate  accounts,  self-funded  employers,  individual  accounts,  Medicare 

Supplement, federal government employees and local government employees. 

4 

 
 
 
 
 
           
           
           
           
           
           
           
           
           
           
           
        
Results of Operations 

Consolidated Operating Results 

The  following  table  sets  forth  our  consolidated  operating  results  for  the  years  ended  December  31, 
2018, 2017 and 2016.  Further details of the results of operations of each reportable segment are included 
in the analysis of operating results for the respective segments. 

(Dollar amounts in millions)

Years ended December 31,
Revenues:

Premiums earned, net
Administrative service fees
Net investment income
Other operating revenues

Total operating revenues
Net realized investment gains
Net unrealized investment losses on equity investments
Other income, net

Total revenues
Benefits and expenses:

Claims incurred
Operating expenses

Total operating costs

Interest expense

Total benefits and expenses

(Loss) income before taxes

Income (benefit) tax expense

Net (loss) income

Net loss attributable to non-controlling interest
Net (loss) income attributable to TSM

2018

2017

2016

$  

2,938.6
14.7
61.9
5.8

$  

2,826.9
16.5
51.6
3.7

$  

2,890.6
17.9
48.9
3.5

3,021.0
0.3
(36.5)
11.3

2,996.1

2,527.6
554.7

3,082.3
6.9

3,089.2

2,898.7
10.8
-
6.6

2,916.1

2,353.1
477.2

2,830.3
6.8

2,837.1

2,960.9
17.4
-
6.5

2,984.8

2,472.2
493.9

2,966.1
7.6

2,973.7

(93.1)
(29.8)
(63.3)
-
(63.3)

$     

79.0
24.5
54.5
-
54.5

$      

11.1
(6.3)
17.4
-
17.4

$      

Year ended December 31, 2018 compared with the year ended December 31, 2017 

Operating Revenues 

Premiums  earned,  net  increased  by  $111.7 million,  or  4.0%,  to  $2.9 billion.    This  increase  primarily 
reflects higher premiums in the Managed Care segment by $99.1 million.  Most of the growth in managed 
care premiums was experienced in the Medicare business, reflecting the achievement of a four-star rated 
Medicare Advantage HMO contract this year, resulting in a 5% bonus applied to the benchmark used in the 
premium calculation, as well as an increase in the 2018 Medicare reimbursement rates.  This increase was 
partially offset by lower managed care membership. 

Administrative service fees decreased $1.8 million, or 10.9%, mainly due to lower membership enrolled 

in this business.  

Net investment income increased $10.3 million, or 20.0%, to $61.9 million as a result of higher invested 

balances and interest rates.  

5 

 
 
 
 
 
        
        
        
        
        
        
          
          
          
    
    
    
          
        
        
       
          
          
        
          
          
    
    
    
    
    
    
      
      
      
    
    
    
          
          
          
    
    
    
       
        
        
       
        
         
       
        
        
          
          
          
Net unrealized investment losses on equity investments 

The $36.5 million in consolidated net unrealized investment losses on equity investments reflects the 
impact of new accounting guidance implemented effective January 1, 2018, which requires the change in 
unrealized  gain  (loss)  of  equity  investments,  previously  recorded  through  comprehensive  income,  to  be 
recorded through earnings. 

Claims Incurred 

Consolidated claims incurred increased by $174.5 million, or 7.4%, to $2.5 billion, mostly driven by an 
increase  in  the  Property  and  Casualty  segment  gross  losses  related  to  Hurricane  Maria,  a  category  4 
hurricane  that  impacted  Puerto  Rico  in  September  2017,  causing  the  segment  to  exceed  its  applicable 
catastrophe reinsurance coverage limits and resulting in $128.7 million unfavorable reserve development 
recorded in 2018.  In addition, in 2017 the Managed Care segment experienced significantly lower utilization 
following the hurricanes that occurred during that year, this hurricane-related drop in utilization is estimated 
to have lowered the Managed Care segment’s claims by approximately $55 million.  The 2017 period also 
includes  $14.8  million  of  losses  related  to  Hurricanes  Irma  and  Maria  recognized  by  the  Property  and 
Casualty segment.  The consolidated loss ratio increased by 280 basis points to 86.0%. 

Operating Expenses 

Consolidated operating expenses increased by $77.5 million, or 16.2%, to $554.7 million.  The higher 
operating expenses are mostly the result of the reinstatement of the HIP Fee of $50.1 million and higher 
professional  services  and  personnel  costs  related  to  the  ongoing  managed  care  initiatives.  The 
consolidated expense ratio increased 200 basis points to 18.8%. 

Income taxes 

Consolidated income tax benefit for the year ended December 31, 2018 was $29.8 million, compared 
to an expense of $24.5 million during the last year, primarily due to a change in the effective tax rate of 
certain  deferred  tax  liabilities  in  the  Company’s  Property  and  Casualty  segment  in  order  to  reflect  the 
expected tax rate at which they will reverse, and a change in the enacted tax rate, from 39% to 37.5%, 
following the Puerto Rico income tax reform enacted in December 2018.  These changes increased the 
deferred tax expense by approximately $9.5 million.  The consolidated income tax expense also reflects 
the  tax  impact  of  net  unrealized  losses  on  equity  investments  and  the  lower  operating  income  of  the 
Managed Care segment. 

Year ended December 31, 2017 compared with the year ended December 31, 2016 

Operating Revenues 

Premiums  earned,  net  decreased  by  $63.7 million,  or  2.2%,  to  $2.8 billion.    This  decrease  primarily 
reflects lower premiums in the Managed Care segment by $58.5 million mainly due to lower membership 
in the segment’s Medicaid and Commercial businesses, the impact of the suspension of the HIP fee pass 
through, and lower Medicare additional risk score revenue. These decreases were partially offset by higher 
average  premium  rates  in  the  Commercial  and  Medicaid  businesses  as  well  as  by  higher  Medicare 
membership.  Property and casualty premiums decreased by $10.7 million year over year, mostly reflecting 
the $9.2 million estimated catastrophe reinsurance reinstatement costs following the impact of Hurricanes 
Irma and Maria in September 2017. 

Administrative service fees decreased $1.4 million, or 7.8%, mainly due to lower membership enrolled 

in this business.  

Net investment income increased $2.7 million, or 5.5%, to $51.6 million mostly as a result of higher 

invested balances. 

6 

 
 
 
Claims Incurred 

Consolidated claims incurred decreased by $119.1 million, or 4.8%, to $2.4 billion, mostly due to lower 
claims in the Managed Care segment offset by an increase in claims in the Property and Casualty segment.  
The decrease in managed care claims primarily reflects lower claims incurred across all businesses in the 
segment  driven  by  the  estimated  decrease  in  utilization  as  a  consequence  of  the  aforementioned 
hurricanes, lower enrollment in the Commercial and Medicaid enrollment, and favorable fluctuations in the 
prior period reserve developments in the Commercial and Medicare businesses. The Property and Casualty 
segment’s estimated net retained losses related to Hurricanes Irma and Maria were approximately $14.8 
million after the application of reinsurance.  The consolidated loss ratio decreased by 230 basis points to 
83.2%.  Excluding the impact of prior-period reserve developments, and moving the Medicare risk score 
revenue and other revenue adjustments to the corresponding period, the managed care MLR for the year 
was 83.7%, 100 basis points lower than the same metric from the prior year. 

Operating Expenses 

Consolidated operating expenses decreased by $16.7 million, or 3.4%, to $477.2 million.  The lower 
operating expenses are mostly the result of the decrease in the HIP Fee of $44.2 million due to the 2017 
moratorium offset by increase in personnel costs, professional services, and business promotion expenses 
totaling approximately $30.4 million. 

Income taxes 

Consolidated income taxes increased by $30.8 million, to a net expense of $24.5 million.   The year 
over  year  change  in  income  taxes  primarily  results  from  an  increase  in  the  taxable  income  from  the 
Managed Care segment, which has a higher effective tax rate than our other segments. 

7 

 
 
Managed Care Segment Operating Results 

We offer our products in the Managed Care segment to three distinct market sectors in Puerto Rico: 
Commercial, Medicare Advantage and Medicaid.  For the year ended December 31, 2018, the Commercial, 
Medicare  and  Medicaid  sectors  represented  26.6%,  38.5%  and  26.4%  of  our  consolidated  premiums 
earned, net, respectively.   

(Dollar amounts in millions)

2018

2017

2016

Operating revenues:

Medical premiums earned, net:

Commercial
Medicare
Medicaid

Medical premiums earned, net

Administrative service fees
Net investment income

Total operating revenues

Medical operating costs:

Medical claims incurred
Medical operating expenses

Total medical operating costs
Medical operating income (loss)

Additional data:

Member months enrollment:

Commercial:

Fully-insured
Self-funded

Total Commercial member months

Medicare member months
Medicaid member months

Total member months

Medical loss ratio
Operating expense ratio

$         

782.8
1,130.3
776.0

$         

803.3
1,035.3
751.4

$         

841.4
1,023.9
783.2

2,689.1
19.1
23.8

2,732.0

2,272.5
433.0

2,590.0
21.6
16.6

2,628.2

2,218.3
354.9

2,648.5
22.4
15.1

2,686.0

2,347.5
375.3

2,705.5
26.5

$           

2,573.2
55.0

$           

2,722.8
(36.8)

$          

3,775,441
1,732,219

5,507,660
1,337,061
4,555,702

3,981,347
1,967,668

5,949,015
1,457,363
4,631,316

4,209,920
2,144,621

6,354,541
1,394,272
4,829,729

11,400,423

12,037,694

12,578,542

84.5%
16.0%

85.6%
13.6%

88.6%
14.1%

Year ended December 31, 2018 compared with the year ended December 31, 2017 

Medical Operating Revenues 

Medical  premiums  earned  increased  by  $99.1  million,  or  3.8%,  to  $2.7  billion.    This  increase  is 

principally the result of the following: 

•  Medical  premiums  generated  by  the  Commercial  business  decreased  by  $20.5  million,  or  2.6%,  to 
$782.8  million.    This  fluctuation  primarily  reflects  lower  fully-insured  enrollment  during  the  year  of 
approximately 206,000 member months offset in part by $12.1 million related to the reinstatement of 
the HIP fee pass-through in 2018 and higher average premium rates.  

•  Medical  premiums  generated  by  the  Medicare  business  increased  by  $95.0  million,  or  9.2%,  to 
$1,130.3 million,  primarily  reflecting  an  increase  in  the  2018  Medicare  reimbursement  rates  fee-for-
service benchmark for the first time since 2012, an increase in rates as the result of attaining a four-
star rating in the Company’s 2018 HMO product, and higher average membership risk score. These 
increases were partially offset by lower enrollment of approximately 120,000 member months.   

8 

 
 
 
 
 
 
 
 
           
           
           
 
 
 
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
   
   
   
•  Medical premiums generated by the Medicaid business increased by $24.6 million, or 3.3%, to $776.0 
million.  This increase primarily reflects higher premiums rates effective July 1, 2017 and $14.5 million 
related to the reinstatement of the HIP fee pass-through.  These increases were offset in part by a lower 
enrollment by approximately 76,000 in member months and the impact of the profit sharing accrual, 
which lowered 2018 premiums by $4.3 million.  The lower membership reflects the lower membership 
assigned by ASES when implementing the current Medicaid contract, which was effective November 
1, 2018.  At the effective date of the current agreement TSS was assigned by ASES approximately 
280,000  subscribers.    After  this  date,  subscribers  had  approximately  three  months  to  select  their 
insurance carrier, during which time TSS was able to compete for membership across Puerto Rico.  As 
of December 31, 2018, our Medicaid membership was approximately 319,000 members. 

Medical Claims Incurred 

Medical claims incurred increased by $54.2 million, or 2.4%, to $2.3 billion.  The MLR of the segment 
decreased 110 basis points during the 2018 period, to 84.5%.  These fluctuations are primarily attributed 
to the net effect of the following: 

•  The medical claims incurred of the Commercial business increased by $22.3 million, or 3.6%, during 
the 2018 period and its MLR, at 82.4%, was 490 basis points higher than the same period last year 
primarily reflecting the decrease in utilization in the 2017 period caused by Hurricanes Irma and Maria.  
The  hurricane  related  decrease  in  utilization  was  estimated  to  lower  2017  claims  by  approximately 
$27.8 million, or 340 basis points of last year’s MLR.  Adjusting for the effect of prior period reserve 
development in 2018 and  2017 period as  well  as adjusting for the 2017  hurricane related  impact in 
utilization, the Commercial MLR would have been approximately 83.4%, 330 basis points higher than 
last year, reflecting claim trends higher than premium trends. 

•  The medical claims incurred of the Medicare business increased by $33.1 million, or 3.6%, during the 
2018 period and its MLR decreased by 450 basis points, to 83.2%.  The hurricane related decrease in 
utilization was estimated to lower 2017 claims by approximately $25.1 million, or 240 basis points of 
last  year’s MLR.  Adjusting for the effect of prior period reserve development in the 2018 and 2017 
periods, moving the risk score revenue to it corresponding period, as well as adjusting for the 2017 
hurricane related impact in utilization, the Medicare MLR would have been approximately 83.9%, 640 
basis points lower than last year, primarily reflecting the higher premium rates in the 2018 period as 
well as cost containment initiatives implemented during the year. 

•  The medical claims incurred of the Medicaid business decreased by $1.1 million, or 0.2%, during the 
2018 period and its MLR decreased by 300 basis points, to 88.5%.  The hurricane related decrease in 
utilization was estimated to lower 2017 claims by approximately $2.2 million, or 30 basis points of last 
year’s MLR.  Adjusting for the effect of prior period reserve developments and the 2018 profit sharing 
accrual, the  Medicaid MLR would  have  been approximately 87.8%,  420 basis points  lower than the 
adjusted  MLR  for  last  year  mostly  reflecting  the  impact  of  higher  premium  rates  in  2018  and  cost 
containment initiatives. 

Medical Operating Expenses 

Medical operating expenses increased by $78.1 million, or 22.0%, to  $433.0 million.  The operating 
expense ratio increased by 240 basis points to 16.0% in 2018.  The higher operating expenses and expense 
ratio are mostly driven by the reinstatement of the HIP fee in 2018, resulting in an increase of $50.1 million, 
and professional services and personnel costs related to ongoing operational and clinical initiatives.  

9 

 
 
 
Year ended December 31, 2017 compared with the year ended December 31, 2016 

Medical Operating Revenues 

Medical  premiums  earned  decreased  by  $58.5  million,  or  2.2%,  to  $2.6  billion.    This  decrease  is 

principally the result of the following: 

•  Medical  premiums  generated  by  the  Commercial  business  decreased  by  $38.1  million,  or  4.5%,  to 
$803.3  million.    This  fluctuation  primarily  reflects  lower  fully-insured  enrollment  during  the  year  of 
approximately  228,600  member  months  and  $14.5  million  related  to  the  suspension  of  the  HIP  fee 
pass-through; offset by an increase in average premium rates of approximately 5%.  

•  Medical premiums generated by the Medicare business increased by $11.4 million, or 1.1%, to $1,035.3 
million, primarily reflecting an increase in member months enrollment of approximately 63,100 lives.  
This increase is partially offset by lower additional risk score revenue by $30.9 million as well as lower 
average premium rates due to a reduction in the 2017 Medicare reimbursement rates.   

•  Medical premiums generated by the Medicaid business decreased by $31.8 million to $751.4 million.  
This  decrease  primarily  reflects  lower  fully-insured  member  months  enrollment  by  approximately 
198,400 lives, $10.8 million related to the suspension of the HIP fee pass-through as a result of the 
2017 moratorium and, the impact of the 2.5% excess profit accrual that increased 2016 premiums by 
$10.9 million.  Decreases are partially offset by a $12.2 million increase in premium collections related 
to our compliance with the contract’s quality incentive metrics and the impact of the new premium rates 
that were effective July 1, 2017, which increased average premium rates by approximately 9%. 

Medical Claims Incurred 

Medical claims incurred decreased by $129.2 million, or 5.5%, to $2.2 billion.  The MLR of the segment 
decreased 300 basis points during the 2017 period, to 85.6%.  These fluctuations are primarily attributed 
to the net effect of the following: 

•  The medical claims incurred of the Commercial business decreased by $94.5 million, or 13.2%, during 
the 2017 period and its MLR, at 77.5%, was 770 basis points lower than the same period last year.  
Adjusting for the effect of prior period reserve developments, the Commercial MLR would have been 
77.9%, 590 basis points lower than the adjusted MLR for last year, primarily reflecting the estimated 
decrease in utilization caused by Hurricanes Irma and Maria in September 2017 as well as the ongoing 
claim  trends  that  are  lower  than  our  premium  trends  following  the  continuity  of  our  underwriting 
discipline.  The estimated decrease in utilization related to the aforementioned hurricanes account for 
approximately 340 of the 590 basis-points decrease in the adjusted MLR. 

•  The medical claims incurred of the Medicare business decreased by $16.6 million, or 1.8%, during the 
2017 period and its MLR decreased by 260 basis points, to 87.7 %.  Adjusting for the effect of prior 
period  reserve  developments  in  2017  and  2016  and  moving  the  additional  risk  score  revenue 
adjustments to their corresponding period, the Medicare MLR would have been approximately 88.4%, 
about 80 basis points lower than last year. The estimated decrease in utilization caused by Hurricanes 
Irma  and  Maria  mitigated  the  impact  of  the  higher  trends  in  Part  B  drugs  and  pharmacy  benefits 
experienced by this business as well as the improvement of benefits in 2017 products taking advantage 
of  the  HIP  fee  moratorium.    The  estimated  decrease  in  utilization  related  to  the  aforementioned 
hurricanes lowered by approximately 240 basis points the adjusted MLR. 

•  The medical claims incurred of the Medicaid business decreased by $18.2 million, or 2.6%, during the 
2017  period  and  its  MLR  increased  by  140  basis  points,  to  91.5%.    Adjusting  for  the  effect  of  prior 
period reserve  developments in 2017  and  2016, as  well as for the impact of the 2.5%  excess profit 
accrual and this year’s quality incentive premiums, the Medicaid MLR would have been approximately 
91.8%,  about  180  basis  points  higher  than  last  year.    The  higher  MLR  primarily  reflects  increased 
pharmacy and outpatient claim trends, partially offset by the estimated decrease in utilization caused 
by Hurricanes Irma and Maria, which lowered the adjusted MLR by 30 basis points, and the impact of 
the higher premium rates that were effective July 1, 2017. 

10 

 
 
 
Medical Operating Expenses 

Medical  operating  expenses  decreased  by  $20.4  million,  or  5.4%,  to  $354.9  million.    The  operating 
expense ratio decreased by 50 basis points to 13.6% in 2017.  The lower operating expenses and expense 
ratio are mostly the result of the decrease in the HIP Fee of $44.2 million due to the 2017 moratorium offset 
by  increase  in  personnel  costs,  professional  services  and  business  promotion  expenses  totaling 
approximately $28.1 million.  

Life Segment Operating Results 

(Dollar amounts in millions)

Years ended December 31,

Operating revenues:

Premiums earned, net:
Premiums earned
Assumed earned premiums
Ceded premiums earned

Premiums earned, net

Net investment income

Total operating revenues

Operating costs:

Policy benefits and claims incurred
Underwriting and other expenses

Total operating costs
Operating income

Additional data:
Loss ratio
Expense ratio

2018

2017

2016

$     

175.3
2.1
(8.8)

$     

166.4
4.2
(8.8)

$     

161.3
4.4
(8.8)

168.6
25.6

194.2

99.0
75.3

161.8
24.8

186.6

87.3
79.9

156.9
24.9

181.8

86.9
73.4

174.3
19.9

$       

167.2
19.4

$       

160.3
21.5

$       

58.7%
44.7%

54.0%
49.4%

55.4%
46.8%

Year ended December 31, 2018 compared with the year ended December 31, 2017 

Operating Revenues 

Premiums earned, net increased by $6.8 million, or 4.2% to $168.6 million, mainly as the result of higher 

sales and improved policy retention in the Individual Life and Cancer lines of business.  

Policy Benefits and Claims Incurred 

Policy  benefits  and  claims  incurred  increased  by  $11.7  million,  or  13.4%,  to  $99.0  million,  mostly 
resulting from higher number of deaths benefits paid in the Individual Life line of business, an increased 
average cost  of claims in the Cancer line of business, and higher  actuarial reserves following  improved 
portfolio persistency.  The segment’s loss ratio increased 470 basis points, to 58.7%. 

Underwriting and Other Expenses 

Decrease in underwriting and other expenses of $4.6 million, or 5.8%, to $75.3 million mostly results 
from a lower amortization of deferred acquisition costs and value of business acquired assets reflecting the 
segment’s improved portfolio persistency.  As a result, the segment’s operating expense ratio improved to 
44.7%, or 470 basis points.  

11 

 
 
 
 
 
          
          
          
         
         
         
       
       
       
         
         
         
       
       
       
         
         
         
         
         
         
       
       
       
Year ended December 31, 2017 compared with the year ended December 31, 2016 

Operating Revenues 

Premiums earned, net increased by $4.9 million, or 3.1% to $161.8 million, as the result of premium 
growth in the segment’s Individual Life and Cancer lines of business, as well as growth in the Costa Rica 
operations.  

Policy Benefits and Claims Incurred 

Policy benefits and claims incurred increased by $0.4 million, or 0.5%, to $87.3 million, mostly reflecting 
a higher volume of business during the year, particularly in the Cancer and Individual Life lines of business, 
which claims increased by $2.7 million, offset by a decrease of $2.3 million in actuarial reserves. 

Underwriting and Other Expenses 

Increase in underwriting and other expenses of $6.5 million, or 8.9%, to $79.9 million mostly reflects 
higher commissions following the segment’s premium growth mentioned above.  In addition, the segment 
has incurred in higher development and marketing expenses related to the expansion of the Costa Rica 
operations.  As a result, the segment’s operating expense ratio increased to 49.4%, or 260 basis points.  

12 

 
 
 
Property and Casualty Segment Operating Results 

(Dollar amounts in millions)

Years ended December 31,

Operating revenues:

Premiums earned, net:
Premiums written
Premiums ceded
Change in unearned premiums

Premiums earned, net

Net investment income

Total operating revenues

Operating costs:

Claims incurred
Underwriting and other operating expenses

2018

2017

2016

$       

139.8
(60.4)
4.1

$       

143.8
(62.3)
(4.3)

$       

133.1
(46.0)
0.8

83.5
10.8

94.3

159.9
44.5

77.2
9.5

86.7

50.8
41.9

87.9
8.9

96.8

40.8
43.9

Total operating costs
Operating (loss) income

204.4
(110.1)

$      

92.7
(6.0)

$         

84.7
12.1

$         

Additional data:
Loss ratio
Expense ratio

191.5%
53.3%

65.8%
54.3%

46.4%
49.9%

Year ended December 31, 2018 compared with the year ended December 31, 2017 

Operating Revenues 

Total premiums written decreased by $4.0 million, or 2.8%, to $139.8 million, driven by lower sales of 
Commercial Package products, mostly the result of selective and disciplined underwriting of Commercial 
risks. 

The premiums ceded to reinsurers decreased by $1.9 million, or 3.0%.  Prior  year premiums ceded 
include approximately $9.2 million of catastrophe reinsurance reinstatement costs. The 2018 includes an 
increase in cessions in the Commercial quota share agreement from 30% in 2017 to 35% effective April 
2018, as well as higher reinsurance costs for facultative and nonproportional property reinsurance. 

The $8.4 million increase in the change in unearned premiums reflects the segments lower premiums 

written in 2018.  

Claims Incurred 

Claims incurred increased by $109.1 million, or 214.8%, to $159.9 million mostly driven by an increase 
in  gross  losses  related  to  Hurricane  Maria,  causing  the  segment  to  exceed  the  applicable  catastrophe 
reinsurance coverage limits and resulting in a $128.7 million unfavorable reserve development.  As loss 
information  emerged,  reserves  have  been  updated  to  reflect  a  worsening  in  the  loss  expectations  for 
Hurricane Maria.  As a result, the segment’s loss ratio increased to 191.5% during this period.  In 2017 we 
recognized $14.8 million of hurricane related net losses. 

Underwriting and Other Expenses 

Underwriting and other operating expenses increased by $2.6 million, or 6.2%, to $44.5 million mostly 
due to higher acquisition expenses, professional services, and personnel costs.  The operating expense 
ratio decreased by 100 basis points, to 53.3% in 2018.  

13 

 
 
 
 
         
         
         
            
           
            
          
          
          
          
            
            
          
          
          
         
          
          
          
          
          
         
          
          
Year ended December 31, 2017 compared with the year ended December 31, 2016 

Operating Revenues 

Total premiums written increased by $10.7 million, or 8.0%, to $143.8 million, driven by higher sales of 
Commercial  Property  and  Commercial  Liability  products, mainly  as  a  result  of  the  acquisition  of  a  large 
account, as well as to higher sales of Personal package products.   

The  premiums  ceded  to  reinsurers  increased  by  $16.3  million,  or  35.4%,  mostly  reflecting  higher 
premiums written in Commercial products during 2017 as well as adjustments related to the catastrophe 
reinsurance, including $9.2 million for catastrophe reinsurance reinstatement costs. 

The change in unearned premiums mostly reflects the segments higher premiums written in 2017.  

Claims Incurred 

Claims incurred increased by $10.0 million, or 24.5%, to $50.8 million mostly driven by $14.8 million of 
net losses related to Hurricanes Irma and Maria.  As a result, the segment’s loss ratio increased by 1,940 
basis points, to 65.8% during this period. 

Underwriting and Other Expenses 

Underwriting and other operating expenses decreased by $2.0 million, or 4.6%, to $41.9 million mostly 
due to lower personnel costs and net commissions.  The operating expense ratio increased by 440 basis 
points, to 54.3% in 2017.  

14 

 
 
 
 
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:  

(Dollar amounts in millions)
Sources (uses) of cash:

Cash provided by operating activities
Net purchases of investment securities
Net capital expenditures
Proceeds from long-term borrowoings
Payments of long-term borrowings
Proceeds from policyholder deposits
Surrenders of policyholder deposits
Repurchase and retirement of common stock
Other

Net (decrease) increase in cash and cash equivalents

2018

2017

2016

$          

$     

$         

7.5
(12.6)
(19.8)
-
(3.2)
18.5
(26.7)
(22.4)
(22.7)
(81.4)

288.9
(154.6)
(21.4)
24.3
(27.1)
13.6
(22.1)
(20.2)
14.1
95.5

6.5
(80.9)
(4.8)
-
(1.7)
18.2
(21.9)
(21.4)
11.6
(94.4)

$       

$       

$      

Year ended December 31, 2018 compared to year ended December 31, 2017 

Cash flow from operating activities decreased by $281.4 million for the year ended December 31, 2018 
as  compared  to  the  year  ended  December  31,  2017,  mostly  reflecting  Property  and  Casualty  hurricane 
related claim payments, last year’s collection of advances from reinsurers, and the 2018 HIP Fee payment; 
offset in part by higher premium collections. 

Decrease  in  net  purchases  of  investments  in  securities  are  part  of  our  asset/liability  management 

strategy using cash on hand. 

In August 2017, the Company’s Board of Directors authorized a $30.0 million repurchase program of 
its  Class  B  common  stock (2017  Repurchase  Program)  and  in  February  2018  the  Company’s  Board  of 
Directors  authorized  a  $25.0  million  expansion  of  this  program.    Repurchases  were  conducted  through 
open-market  purchases  of  Class  B  shares  only,  in  accordance  with  Rule  10b-18  under  the  Securities 
Exchange Act of 1934, as amended. During the year 2018, the Company repurchased and retired 903,888 
shares of our Class B Common Stock shares at an average per share price of $24.76, for an aggregate 
cost of $22.4 million. 

Increase in Other is due to the change in outstanding checks in excess of bank balances. 

Year ended December 31, 2017 compared to year ended December 31, 2016 

Cash flow from operating activities increased by $279.7 million for the year ended December 31, 2017 
as compared to the year ended December 31, 2016, principally due to, lower claims paid, a decrease in 
cash paid to suppliers and employees; partially offset by lower premium collections.   

Increase  in  net  purchases  of  investments  in  securities  are  part  of  our  asset/liability  management 

strategy using cash on hand. 

Net  capital  expenditures  increased  by  $16.6  million  for  the  year  ended  December  31,  2017  mostly 

related to information technology initiatives in the Managed Care segment. 

During the  year 2017,  we received  the remaining  $24.3 million from a loan  with  a commercial bank 
related with a credit agreement entered into in December 2016. These proceeds were used to prepay the 
outstanding principal amount of $24.0 million of the 6.6% senior unsecured notes. 

15 

 
 
         
      
        
         
        
         
           
         
          
          
        
         
          
         
         
         
        
        
         
        
        
         
         
         
During the year 2017, the Company repurchased and retired 861,415 shares of our Class B Common 
Stock shares under the 2017 Repurchase Program.  Repurchases  were made at an average per share 
price of $23.38, for an aggregate cost of $20.2 million. 

Stock Repurchase Program 

The Company repurchases shares through open market transactions, in accordance with Rule 10b-18 
of the Securities Exchange Act of 1934, as amended, under repurchase programs authorized by the Board 
of Directors.  Shares purchased under share repurchase programs are retired and returned to authorized 
and  unissued  status.  See  Note  19,  Stock  Repurchase  Program,  of  the  Notes  to  Consolidated  Financial 
Statements of this Annual Report. 

Financing and Financing Capacity 

We have several short-term facilities available to address timing differences between cash collections 
and disbursements.  These short-term facilities are mostly in the form of arrangements to sell securities 
under repurchase agreements.  As of December 31, 2018, we had $60.0 million of available credit under 
these facilities.  There are no outstanding short-term borrowings under these facilities as of December 31, 
2018. 

On December 28, 2016, TSM entered into a $35.5 million credit agreement with a commercial bank in 
Puerto Rico. The agreement consists of three term loans: (i) Term Loan A in the principal amount of $11.2 
million, (ii) Term Loan B in the principal amount of $20.2 million and (iii) Term Loan C in the principal amount 
of $4.1 million. Term Loan A matures in October 2023 while the Term Loans B and C mature in January 
2024.  Term Loan A was used to refinance a previous $41.0 million secured loan payable with the same 
commercial bank.  Pursuant to the credit agreement, interest is payable on the outstanding balance of the 
Loan at the following annual rate: (i) 1% over LIBOR for Term Loan A, (ii) 2.75% over LIBOR for Term Loan 
B,  and  (iii)  3.25%  over  LIBOR  for  Term  Loan  C.    The  loan  includes  certain  financial  and  non-financial 
covenants,  which  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  and dividends.  
Failure to meet these covenants may trigger the accelerated payment of the outstanding balance.  As of 
December 31, 2018 we are in compliance with these covenants.  

On April 18, 2017, TSA entered into a $10.0 million revolving loan agreement with a commercial bank 
in Puerto Rico. This line of credit has an interest rate of 30-day LIBOR plus 25 basis points contains certain 
financial and non-financial covenants that are customary for this type of facility. This line of credit had an 
original maturity date of April 17, 2018 and was renewed for an additional year, maturing on April 30, 2019. 

We anticipate that we will have sufficient liquidity to support our currently expected needs. 

Contractual Obligations 

Our  contractual  obligations  impact  our  short  and  long-term  liquidity  and  capital  resource  needs.  
However, our future cash flow prospects cannot be reasonably assessed based solely on such obligations.  
Future cash outflows, whether contractual or not, will vary based on our future needs.  While some cash 
outflows are completely fixed (such as commitments to repay principal and interest on borrowings), most 
are dependent on future events (such as the payout pattern of claim liabilities which have been incurred 
but not reported). 

•  The table below describes the payments due under our contractual obligations, aggregated by type of 
contractual obligation, including the maturity profile of our debt, operating leases and other long-term 
liabilities, but excludes an estimate of the future cash outflows related to the following: 
o 

Alternative  investments  –  The  Company  has  $80.5  million  of  unfunded  capital  commitments 
related to alternative investments.  These commitments were excluded from this disclosure due 
to the undetermined timing of their cash flows. 
Unearned  premiums  –  This  amount  accounts  for  the  premiums  collected  prior  to  the  end  of 
coverage period and does not represent a future cash outflow.  As of December 31, 2018, we 
had $83.0 million in unearned premiums. 

o 

16 

 
o 

o 

Policyholder deposits – The cash outflows related to these instruments are not included because 
they  do  not  have  defined  maturities,  such  that  the  timing  of  payments  and  withdrawals  is 
uncertain.    There  are  currently  no  significant  policyholder  deposits  in  paying  status.    As  of 
December 31, 2018, our policyholder deposits had a carrying amount of $174.1 million. 
Other long-term liabilities – Due to the indeterminate nature of their cash outflows, $79.4 million 
of other long-term liabilities are not reflected in the following table, consisting of $31.3 million of 
liability for pension benefits, $3.2 million in deferred tax liabilities, and $44.9 million in liabilities 
to the Federal Employees’ Health Benefits Plan Program. 

Contractual obligations by year

(Dollar amounts in millions)

Total

2019

2020

2021

2022

2023

Thereafter

Long-term borrowings (1)
Operating leases
Purchase obligations (2)
Claim liabilities (3)
Estimated obligation for future
     policy benefits (4)

$         

33.0
11.3
257.2
611.8

$          

4.1
5.2
221.8
483.7

$          

4.2
3.0
13.5
95.0

$          

4.0
1.7
6.9
7.8

$          

3.9
1.2
4.1
9.5

$          

3.5
0.2
4.0
6.3

$         

13.3
-
6.9
9.5

670.6
1,583.9

$    

131.2
846.0

$       

117.6
233.3

$       

111.7
132.1

$       

105.7
124.4

$       

100.2
114.2

$       

104.2
133.9

$       

(1)  As  of  December  31,  2018,  our  long-term  borrowings  consist  of  a  credit  agreement  entered  with  a 
commercial bank in Puerto Rico.  See the “Financing and Financing Capacity” section for additional 
information regarding our long-term borrowings. 

(2)  Purchase obligations represent payments required by us under material agreements to purchase goods 
or  services  that  are  enforceable  and  legally  binding  and  where  all  significant  terms  are  specified, 
including: quantities to be purchased, price provisions and the timing of the transaction.  Other purchase 
orders made in the ordinary course of business for which we are not liable are excluded from the table 
above.  Estimated pension plan contributions amounting to $2.0 million were included within the total 
purchase obligations. However, this amount is an estimate which may be subject to change in view of 
the  fact  that  contribution  decisions  are  affected  by  various  factors  such  as  market  performance, 
regulatory and legal requirements and plan funding policy. 

(3)  Claim liabilities represent the amount of our claims processed and incomplete as well as an estimate 
of the amount of incurred but not reported claims and loss-adjustment expenses.  This amount does 
not  include an estimate of claims to be incurred subsequent to December 31,  2018.  The expected 
claims payments are an estimate and may differ materially from the actual claims payments made by 
us  in  the  future.    Also,  claim  liabilities  are  presented  gross,  and  thus  do  not  reflect  the  effects  of 
reinsurance under which $325.0 million of reserves had been ceded at December 31, 2018. 

(4)  Our  Life  segment  establishes,  and  carries  as  liabilities,  actuarially  determined  amounts  that  are 
calculated  to  meet  its  policy  obligations  when  a  policy  matures  or  surrenders,  an  insured  dies  or 
becomes  disabled  or  upon  the  occurrence  of  other  covered  events.    A  significant  portion  of  the 
estimated obligation for future policy benefits to be paid included in this table considers contracts under 
which we are currently not making payments and will not make payments until the occurrence of an 
insurable event not under our control, such as death, illness, or the surrender of a policy.  We have 
estimated the timing of the cash flows related to these contracts based on historical experience as well 
as expectations of future payment patterns.  The amounts presented in the table above represent the 
estimated cash payments for benefits under such contracts based on assumptions related to the receipt 
of  future  premiums  and  assumptions  related  to  mortality,  morbidity,  policy  lapses,  renewals, 
retirements, disability incidence and other contingent events as appropriate for the respective product 
type.  All estimated cash payments included in this table are not discounted to present value nor do 
they take into account estimated future premiums on policies in-force as of December 31, 2018 and 
are gross of any reinsurance recoverable.  The $670.6 million total estimated cash flows for all years 
in the table is different from the liability of future policy benefits of $361.5 million included in our audited 
consolidated financial statements principally due to the time value of money.  Actual cash payments to 
policyholders could differ significantly from the estimated cash payments as presented in this table due 
to  differences  between  actual  experience  and  the  assumptions  used  in  the  estimation  of  these 
payments. 

17 

 
 
          
            
            
            
            
            
            
         
         
          
            
            
            
            
         
         
          
            
            
            
            
         
         
         
         
         
         
         
Off-Balance Sheet Arrangements 

We have no off-balance sheet arrangements that have or are reasonably likely to have a current or 
future  material  effect  on  our  financial  condition,  revenues  and  expenses,  results  of  operations,  liquidity, 
capital expenditures or capital resources. 

Restriction on Certain Payments by the Corporation’s Subsidiaries 

Our insurance subsidiaries are subject to the regulations of the Commissioner of Insurance of Puerto 
Rico.  These regulations, among other things, require insurance companies to maintain certain levels of 
capital, thereby restricting the amount of earnings that can be distributed by the insurance subsidiaries to 
TSM.  As of December 31, 2018, our insurance subsidiaries, except for TSP, were in compliance with such 
minimum capital requirements. TSP is currently under a plan to increase its statutory capital and surplus 
and RBC scores.   

These regulations are not directly applicable to TSM, as a holding company, since it is not an insurance 

company. 

The $35.5 million credit agreement limits the amount of dividends or other distributions (including share 

repurchases) payable by the Corporation to $50 million per year.  

We do not expect that any of the previously described dividend restrictions will have a significant effect 

on our ability to meet our cash obligations. 

Solvency Regulation 

To monitor the solvency of the operations, the BCBSA requires us, TSS, TSA, and TSB to comply with 
certain  specified  levels  of  Risk  Based  Capital  (”RBC”).    RBC  is  designed  to  identify  weakly  capitalized 
companies by comparing each company’s adjusted surplus to its required surplus (RBC ratio).  The RBC 
ratio reflects the risk profile of insurance companies.  At December 31, 2018, TSM and TSS estimated RBC 
ratio was above the 375% minimum BCBSA RBC requirement to avoid monitoring.  At December 31, 2018, 
TSA estimated RBC ratio was above the minimum BCBSA RBC requirement of 100% for smaller controlled 
affiliate. 

BCBSA’s primary licensees could be subject to monitoring if, over a 6 or 12 month period, its RBC ratio 

declines by 80 or more points and which results in a level that is below 500%. 

Other Contingencies 

Legal Proceedings 

Various  litigation  claims  and  assessments  against  us  have  arisen  in  the  course  of  our  business, 
including but not limited to, our activities as an insurer and employer.  Furthermore, the Commissioner of 
Insurance, as well as other Federal, Puerto Rico, and Costa Rica government authorities, regularly make 
inquiries  and  conduct  audits  concerning  our  compliance  with  applicable  insurance  and  other  laws  and 
regulations. 

Given the inherent unpredictability of these matters, it is possible that an adverse outcome in certain 
matters could, from time to time, have an adverse effect on our operating results and/or cash flows.  For a 
description of our legal proceedings, see Note 24, Contingencies, of the Notes to Consolidated Financial 
Statements, included in this Annual Report. 

Guarantee Associations and Other Regulatory Commitments 

To operate in Puerto Rico, insurance companies, such as our insurance subsidiaries, are required to 
participate  in  guarantee  associations,  which  are  organized  to  pay  policyholders  contractual  benefits  on 
behalf of insurers declared insolvent.  These associations levy assessments, up to prescribed limits, on a 
proportional basis, to all member insurers in the line of business in which the insolvent insurer was engaged.  
In  accordance  with  insurance  laws  and  regulations,  assessments  are  recoverable  through  policy 
surcharges.  In  January  2019,  a  local  property  and  casualty  insurance  company  entered  a  liquidation 

18 

 
process, accordingly, the property and casualty guarantee fund has initiated the process to settle unpaid 
claims  and  return  unearned  premiums  of  the  insolvent  insurer.    The  guarantee  fund  currently  has  not 
determined  and  imposed  assessments  to  cover  claims  and  return  premiums.    Annual  assessments  are 
limited  to  2%  of  direct  premiums  written,  as  defined.    During  2018,  2017  and  2016,  no  assessment  or 
payment was made for this contingency.  It is the opinion of management that any possible future guarantee 
association assessments will not have a material effect on our operating results and/or cash flows, although 
there is no ceiling on these payment obligations. 

Pursuant  to  the  Puerto  Rico  Insurance  Code,  our  Property  and  Casualty  subsidiary  is  a  member  of 
Sindicato  de  Aseguradores  para  la  Suscripción  Conjunta  de  Seguros  de  Responsabilidad  Profesional 
Médico-Hospitalaria  (SIMED).    The  syndicate  was  organized  for  the  purpose  of  underwriting  medical-
hospital professional liability insurance.  As a member, the Property and Casualty segment shares risks 
with  other  member  companies  and,  accordingly,  is  contingently  liable  in  the  event  the  syndicate  cannot 
meet  their  obligations.    During  2018,  2017  and  2016,  no  assessment  or  payment  was  made  for  this 
contingency.  It is the opinion of management that any possible future syndicate assessments will not have 
a material effect on our operating results and/or cash flows, although there is no ceiling on these payment 
obligations.  In December 2018, SIMED declared a distribution to its members; the Company’s share of this 
distribution  was  $2.9  million,  which  is  presented  with  other  income  in  the  accompanying  consolidated 
statement of earnings. 

In addition, our Property and Casualty insurance subsidiary is a member of the Compulsory Vehicle 
Liability Insurance Joint Underwriting Association (the “Association”).  The Association was organized in 
1997 to underwrite insurance coverage of motor vehicle property damage liability risks effective January 1, 
1998.  As a participant, the segment shares the risk proportionally with other members based on a formula 
established by the Insurance Code.  During the years 2018 and 2016, the Association distributed to the 
Company an amount based on the good experience of the business amounting to $0.2 million and $0.5 
million, respectively.  In June 2017, the Association declared a special dividend of $70 million as authorized 
by a recent amendment to the Act creating the Association.  The distribution was subject to a unique and 
special tax rate of 50%.  The dividend was paid net of its related tax in December 2018.  The share of the 
Property and Casualty segment in this distribution was $2.4 million. 

The  Property  and  Casualty  segment  is  also  member  of  the  Puerto  Rico  Fire  and  Allied  Lines 
Underwriting  Association  and  the  Puerto  Rico  Auto  Assign  Plan.    These  entities  periodically  impose 
assessments to cover operations and other charges.  The assessments recorded from these entities were 
$9 thousand in 2018 and $1 thousand in 2017 and 2016. 

Critical Accounting Estimates 

Our consolidated financial statements and accompanying notes included in this Annual Report on Form 
10-K  have  been  prepared  in  accordance  with  GAAP  applied  on  a  consistent  basis.    The  preparation  of 
financial statements in conformity with GAAP requires management to make estimates and assumptions 
that affect the reported amounts of assets and liabilities, the disclosure of contingent assets and liabilities 
at  the  date  of  the  financial  statements  and  the  reported  amounts  of  revenues  and  expenses  during  the 
reporting  period.  We continually  evaluate the accounting policies  and estimates  we  use to  prepare our 
consolidated financial statements.  In general, management’s estimates are based on historical experience 
and various other assumptions it believes to be reasonable under the circumstances.  The following is an 
explanation  of  our  accounting  policies  considered  most  significant  by  management.    These  accounting 
policies require us to make estimates and assumptions that affect the amounts reported in the consolidated 
financial statements and accompanying notes.  Such estimates and assumptions could change in the future 
as more information is known.  Actual results could differ materially from those estimates. 

The policies discussed below are considered by management to be critical to an understanding of our 
consolidated  financial  statements  because  their  application  places  the  most  significant  demands  on 
management’s judgment, with financial reporting results relying on estimation about the effect of matters 
that  are  inherently  uncertain.    For  all  these  policies,  management  cautions  that  future  events  may  not 
necessarily develop as forecasted, and that the best estimates routinely require adjustment.  Management 
believes that the amounts provided for these critical accounting estimates are adequate. 

19 

 
 
 
Claim Liabilities 

Claim liabilities by segment as of December 31, 2018 were as follows: 

(Dollar amounts in millions)

Managed care
Property and casualty insurance
Life insurance
      Consolidated

$       

$       

393.7
496.9
46.2
936.8

Management  continually  evaluates  the  potential  impact  of  changes  in  the  factors  considered  for  its 
claim liabilities estimates, both positive and negative, and uses the results of these evaluations to adjust 
recorded claim liabilities and underwriting criteria.  Our profitability depends in large part on our ability to 
accurately predict and effectively manage the amount of claims incurred, particularly those of the Managed 
Care segment and the losses arising from the Life and Property and Casualty segments.  Management 
regularly  reviews  its  premiums  and  benefits  structure  to  reflect  our  underlying  claims  experience  and 
revised actuarial data; however, several factors could adversely affect our underwriting results.  Some of 
these factors are beyond management’s control and could adversely affect its ability to accurately predict 
and  effectively  control  claims  incurred.    Examples  of  such  factors  include  changes  in  health  practices, 
economic conditions, change in utilization trends including those caused by epidemic conditions, healthcare 
costs, the advent of natural disasters, and malpractice litigation.  Costs in excess of those anticipated could 
have a material adverse effect on our results of operations. 

We recognize claim liabilities as follows: 

Managed Care Segment 

At December 31, 2018, claim liabilities for the Managed Care segment amounted to $393.7 million and 
represented 42.0% of our total consolidated claim liabilities and 20.3% of our total consolidated liabilities. 

Claim liabilities are determined employing actuarial methods that are commonly used by managed care 
actuaries  and  meet  Actuarial  Standards  of  Practice,  which  require  that  the  claim  liabilities  be  adequate 
under moderately adverse circumstances.  The segment determines the amount of the liability by following 
a detailed actuarial process that entails using both historical claim payment patterns as well as emerging 
medical  cost  trends  to  project  a  best  estimate  of  claim  liabilities.   Under  this  process,  historical  claims 
incurred dates are compared to  actual dates  of claims payment.   This information  is analyzed to create 
“completion” or “development” factors that represent the average percentage of total incurred claims that 
have been paid through a given date after being incurred.  Completion factors are applied to claims paid 
through  the  financial  statement  date  to  estimate  the  ultimate  claim  expense  incurred  for  the  current 
period.  Actuarial  estimates of claim liabilities are then determined by subtracting the actual paid claims 
from the estimate of the total expected claims incurred.  The majority of unpaid claims, both reported and 
unreported, for any period, are those claims which are incurred in the final months of the period.  Since the 
percentage of claims paid during the period with respect to claims incurred in those months is generally 
very low, the above-described completion factor methodology is less reliable for such months.  In order to 
complement  the  analysis  to  determine  the  unpaid  claims,  historical  completion  factors  and  payment 
patterns are applied to incurred and paid claims for the most recent twelve months and compared to the 
prior twelve month period.  Incurred claims for the most recent twelve months also take into account recent 
claims expense levels and health care trend levels (trend factors).  Using all of the above methodologies, 
our actuaries determine based on the different circumstances the unpaid claims as of the end of period.   

Because the reserve methodology is based upon historical information, it must be adjusted for known 
or suspected operational and environmental changes.  These adjustments are made by our actuaries based 
on their knowledge and their estimate of emerging impacts to benefit costs and payment speed. 

20 

 
 
 
 
         
          
Managed care claim liabilities also include a provision for adverse deviation, which is an estimate for 
known environmental factors that are reasonably likely to affect the required level of reserves. This provision 
for adverse deviation is intended to capture the potential adverse development from known environmental 
factors such as our entry into new geographical markets, changes in our geographic or product mix, the 
introduction  of  new  customer  populations,  variation  in  benefit  utilization,  disease  outbreaks,  changes  in 
provider  reimbursement,  fluctuations  in  medical  cost  trend,  variation  in  claim  submission  patterns  and 
variation  in  claims  processing  speed  and  payment  patterns,  changes  in  technology  that  provide  faster 
access  to  claims  data  or  change  the  speed  of  adjudication  and  settlement  of  claims,  variability  in  claim 
inventory  levels,  non-standard  claim  development,  and/or  exceptional  situations  that  require  judgmental 
adjustments in setting the reserves for claims. 

Circumstances  to  be  considered  in  developing  our  best  estimate  of  reserves  include  changes  in 
enrollment,  utilization  levels,  unit  costs,  mix  of  business,  benefit  plan  designs,  provider  reimbursement 
levels,  processing  system  conversions  and  changes,  claim  inventory  levels,  regulatory  and  legislative 
requirements,  claim  processing  patterns,  and  claim  submission  patterns.    A  comparison  or  prior  period 
liabilities to re-estimated claim liabilities based on subsequent claims development is also considered in 
making the liability determination.  In the actuarial process, the methods and assumptions are not changed 
as  reserves  are  recalculated,  but  rather  the  availability  of  additional  paid  claims  information  drives  our 
changes in the re-estimate of the unpaid claim liability.  Changes in such development are recorded as a 
change to current period benefit expense.  The re-estimates or recasts are done monthly for the previous 
four calendar quarters.  On average, about 91% of the claims are paid within three months after the last 
day of the month in which they were incurred and about 5% are within the next three months, for a total of 
96% paid within six months after the last day of the month in which they were incurred. 

Management regularly  reviews its  assumptions regarding claim liabilities  and makes adjustments to 
claims incurred when necessary.  If management’s assumptions regarding cost trends and utilization are 
significantly different than actual results, our consolidated statement of earnings and financial position could 
be impacted in future periods.  Changes to prior year estimates may result in an increase in claims incurred 
or  a  reduction  of  claims  incurred  in  the  period  the  change  is  made.    Further,  due  to  the  considerable 
variability of health care costs, adjustments to claims liabilities are made in each period and are sometimes 
significant as compared to the net income recorded in that period.  Prior year development of claim liabilities 
is recognized immediately upon the actuary’s judgment that a portion of the prior year liability is no longer 
needed  or  that  an  additional  liability  should  have  been  accrued.    Health  care  trends  are  monitored  in 
conjunction  with  the  claim  reserve  analysis.    Based  on  these  analyses,  rating  trends  are  adjusted  to 
anticipate future changes in health care cost or utilization.  Thus, the Managed Care segment incorporates 
those trends as part of the development of premium rates in an effort to keep premium rating trends in line 
with claims trends. 

21 

 
 
 
As described above, completion factors and claims trend factors can have a significant impact on the 
determination  of  our  claim  liabilities.    The  following  example  provides  the  estimated  impact  on  our 
December 31, 2018 claim liabilities, assuming the indicated hypothetical changes in completion and trend 
factors: 

(Dollar amounts in millions)

Completion Factor 1
(Decrease) Increase

Claims Trend Factor 2
(Decrease) Increase

In completion factor

In unpaid claim
liabilities

In claims trend
factor

In unpaid claim
liabilities

-1.2%

-0.8%
-0.4%
0.4%
0.8%
1.2%

$20.3

13.4
6.7
(6.7)
(13.3)
(19.7)

1.5%

1.0%
0.5%
-0.5%
-1.0%
-1.5%

$17.6

11.7
5.9
(5.9)
(11.7)
(17.6)

(1)  Assumes (decrease) increase in the completion factors for the most recent twelve months. 
(2)  Assumes (decrease) increase in the claims trend factors for the most recent twelve months. 

The segments’ reserving practice is to consistently recognize the actuarial best estimate as the ultimate 
liability for claims within a level of confidence required by actuarial standards.  Management believes that 
the  methodology  for  determining  the  best  estimate  for  claim  liabilities  at  each  reporting  date  has  been 
consistently applied. 

Amounts  incurred  related  to  prior  years  vary  from  previously  estimated  liabilities  as  the  claims  are 
ultimately  settled.    Liabilities  at  any  year-end  are  continually  reviewed  and  re-estimated  as  information 
regarding  actual  claims  payments,  or  run-out  becomes  known.    This  information  is  compared  to  the 
originally established year-end liability.  Negative amounts reported for incurred claims related to prior years 
result from claims being settled for amounts less than originally estimated.  The reverse is true of reserve 
shortfalls.  Medical claim liabilities are usually described as having a “short tail”, which means that they are 
generally paid within several months of the member receiving service from the provider.  Accordingly, the 
majority, or approximately 93%, of any redundancy or shortfall relates to claims incurred in the previous 
calendar year-end, with the remaining 7% related to claims incurred prior to the previous calendar year-
end.  Management has not noted any significant emerging trends in claim frequency and severity and the 
normal fluctuations in enrollment and utilization trends from year to year. 

22 

 
 
 
 
The  following  table  shows  the  variance  between  the  segment’s  incurred  claims  for  current  period 
insured  events  and  the  incurred  claims  for  such  years  had  they  been  determined  retrospectively  (the 
“Incurred claims related to current period insured events” for the year shown plus or minus the “Incurred 
claims related to prior period insured events” for the following year as included in Note 11, Claim Liabilities 
and Claim Adjustment Expenses, of the Notes to Consolidated Financial Statements, included in Annual 
Report.    This  table  shows  that  the  segments’  estimates  of  this  liability  have  approximated  the  actual 
development. 

(Dollar amounts in millions)

Years ended December 31,
Total incurred claims:
As reported (1)
On a retrospective basis

Variance

Variance to total incurred claims as reported

2017

2016

2015

$   

2,231.1
2,195.1

$   

2,356.6
2,343.8

$   

2,216.3
2,207.3

$        

36.0

$        

12.8

$          

9.0

1.6%

0.5%

0.4%

(1)  Includes total claims incurred less adjustments for prior year reserve development. 

Management expects that substantially all of the development of the 2018 estimate of medical claims 

payable will be known during 2019. 

In the event this segment experiences an unexpected increase in health care cost or utilization trends, 

we have the following options to cover claim payments: 

•  Through the management of our cash flows and investment portfolio. 
• 

In the Commercial business we have the ability to increase the premium rates throughout the year in 
the monthly renewal process, when renegotiating the premiums for the following contract year of each 
group as they become due.  We consider the actual claims trend of each group when determining the 
premium rates for the following contract year. 

•  We have available short-term borrowing facilities that from time to time address differences between 

cash receipts and disbursements. 

For additional information on our credit facilities, see section “Financing and Financing Capacity”. 

Life Segment 

At December 31, 2018, claim liabilities for the life segment amounted to $46.2 million and represented 

5.0% of total consolidated claim liabilities and 2.4% of our total consolidated liabilities. 

The claim liabilities related to the life segment are based on methods and underlying assumptions in 
accordance with GAAP.  The estimate of claim liabilities for this segment is based on the amount of benefits 
contractually  determined  for  reported  claims,  and  on  estimates  based  on  past  experience  modified  for 
current trends, for unreported claims.  This estimate relies on observations of ultimate loss experience for 
similar historical events. 

Claim  reserve  reviews  are  generally  conducted  on  a  monthly  basis,  in  light  of  continually  updated 
information.  We  review  reserves  using  current  inventory  of  policies  and  claims  data.    These  reviews 
incorporate a variety of actuarial methods, judgments and analysis. 

The key assumption with regard to claim liabilities for our life segment is related to claims incurred prior 
to the end of the year, but not yet reported to our subsidiary.  A liability for these claims is estimated based 
upon  experience  with  regards  to  amounts  reported  subsequent  to  the  close  of  business  in  prior  years.  
There are uncertainties in the development of these estimates; however, in recent years our estimates have 
resulted in immaterial redundancies or deficiencies. 

23 

 
 
 
 
     
     
     
Property and Casualty Segment 

At  December  31,  2018,  claim  liabilities  for  the  Property  and  Casualty  segment  amounted  to  $496.9 
million and represented 53.0% of the total consolidated claim liabilities and 25.6% of our total consolidated 
liabilities.  Claims liabilities related to losses caused by Hurricanes Irma and Maria amount to approximately 
$415.9 million. 

Estimates  of  the  ultimate  cost  of  claims  and  loss-adjustment  expenses  of  this  segment  are  based 
largely  on  the  assumption  that  past  developments,  with  appropriate  adjustments  due  to  known  or 
unexpected changes, are a reasonable basis on which to predict future events and trends, and involve a 
variety of actuarial techniques that analyze current experience, trends and other relevant factors.  Property 
and casualty insurance claim liabilities are categorized and tracked by line of business.  Medical malpractice 
policies are written on a claims-made basis.  Policies written on a claims-made basis require that claims be 
reported during the policy period.  Other lines of business are written on an occurrence basis.  Hurricane 
losses initially include the use of models from industry recognized firms having data, historical and current 
information about the events, to estimate ultimate losses.  These estimates are supplemented by internal 
estimates of other costs deemed necessary to develop the ultimate losses.  As loss information emerges, 
claims are separated between those with solid estimates and the remained claims.  Additional reserves are 
provided based on paid loss experience for unreported, potential development, and loss expenses.    

Individual case estimates for reported claims are established by a claims adjuster and are changed as 
new information becomes available during the course of handling the claim.  Our property  and casualty 
business, other than medical malpractice, is primarily short-tailed business, where losses (e.g. paid losses 
and case reserves) are generally reported quickly. 

Claim  reserve  reviews  are  generally  conducted  on  a  quarterly  basis,  in  light  of  continually  updated 
information.  Our actuary certifies reserves for both current and prior accident years using current claims 
data.  These reviews incorporate a variety of actuarial methods, judgments, and analysis.  For each line of 
business,  a  variety  of  actuarial  methods  are  used,  with  the  final  selections  of  ultimate  losses  that  are 
appropriate  for  each  line  of  business  selected  based  on  the  current  circumstances  affecting  that  line  of 
business.  These selections incorporate input from management, particularly from the claims, underwriting 
and operations divisions, about reported  loss cost trends and other factors that  could affect the reserve 
estimates. 

Key assumptions are based on the consideration that past emergence of paid losses and case reserves 
is credible and likely indicative of future emergence and ultimate losses.  A key assumption is the expected 
loss ratio for the current accident year.  This expected loss ratio is generally determined through a review 
of  the  loss  ratios  of  prior  accident  years  and  expected  changes  to  earned  pricing,  loss  costs,  mix  of 
business, and other factors that are expected to impact the loss ratio for the current accident year.  Another 
key  assumption  is  the  development  patterns  for  paid  and  reported  losses  (also  referred  to  as  the  loss 
emergence and settlement patterns).  The reserves for unreported claims for each  year are  determined 
after reviewing the  indications produced  by  each  actuarial projection method,  which,  in turn, rely  on  the 
expected paid and reported development patterns and the expected loss ratio for that year. 

At December 31, 2018, the claim liabilities of the Property and Casualty segment fall within the actuarial 
reserve range determined by the actuaries.  Management reviews the results of the reserve estimates in 
order  to  determine  any  appropriate  adjustments  in  the  recording  of  reserves.   Adjustments  to  reserve 
estimates are made after management’s consideration of numerous factors, including but not limited to the 
magnitude of the difference between the actuarial indication and the recorded reserves, improvement or 
deterioration of actuarial indications in the period, the maturity of the accident year, trends observed over 
the recent past and the level of volatility within a particular line of business.  In general, changes are made 
more quickly to more mature accident years and less volatile lines of business.  Varying the net expected 
loss ratio by +/-1% in all lines of business for the six most recent accident years would increase/decrease 
the claims incurred by approximately $5.0 million. 

24 

 
 
 
Liability for Future Policy Benefits 

Our  Life  segment  establishes,  and  carries  as  liabilities,  actuarially  determined  amounts  that  are 
calculated to meet its policy obligations when a policy matures or surrenders, an insured dies or becomes 
disabled or upon the occurrence of other covered events.  We compute the amounts for actuarial liabilities 
in conformity with GAAP. 

Liabilities for future policy benefits for whole life and term insurance products and active life reserves 
for accident and health products are computed by the net level premium method, using interest assumptions 
ranging from 3.90% to 5.75% and withdrawal, mortality, morbidity and maintenance expense assumptions 
appropriate at the time the policies were issued (or when a block of business was purchased, as applicable).  
Accident and health unpaid claim reserves are stated at amounts determined by estimates on individual 
claims and estimates of unreported claims based on past experience.  Deferred annuity reserves are carried 
at the account value. 

For deferred annuities, the liability for future policy benefits is equal to total policy account values.  The 
liabilities for all other products are based upon a variety of actuarial assumptions that are uncertain.  The 
most  significant  of  these  assumptions  is  the  level  of  anticipated  death  and  health  claims.    Other 
assumptions  that are less  significant to the appropriate  level of the  liability for future  policy benefits are 
anticipated policy persistency rates, investment yields, and operating expense levels.  These are reviewed 
frequently by our subsidiary’s external actuaries, to assure that the current level of liabilities for future policy 
benefits  is  sufficient,  in  combination  with  anticipated  future  cash  flows,  to  provide  for  all  contractual 
obligations.  For all products, except for deferred annuities, the basis for the liability for future policy benefits 
is established at the time of issuance of each contract and would only change if our experience deteriorates 
to the point that the level of the liability is not adequate to provide for future policy benefits.  We do not 
currently expect that level of deterioration to occur. 

Deferred Policy Acquisition Costs and Value of Business Acquired 

Certain costs for acquiring life and property and casualty insurance business are deferred.  Acquisition 

costs related to the Managed Care segment are expensed as incurred. 

The  costs  of  acquiring  new  life  business,  principally  commissions,  and  certain  variable  underwriting 
and  policy  issue  expenses  of  our  Life  segment,  have  been  deferred.    These  costs,  including  value  of 
business acquired (“VOBA”) recorded upon our acquisitions of TSV and TSB, are amortized to income over 
the premium-paying period of the related whole life and term insurance policies in proportion to the ratio of 
the expected annual premium revenue to the expected total premium revenue, and over the anticipated 
lives of universal life policies in proportion to the ratio of the expected annual gross profits to the expected 
total gross profits.  The expected premiums revenue and gross profits are based upon the same mortality 
and withdrawal assumptions used in determining the liability for future policy benefits.  For universal life 
and  deferred  annuity  policies,  changes  in  the  amount  or  timing  of  expected  gross  profits  result  in 
adjustments to the cumulative amortization of these costs.  The effect on the amortization of deferred policy 
acquisition costs (“DPAC” or “DAC”) of revisions to estimated gross profits is reported in earnings in the 
period such estimated gross profits are revised. 

The schedules of amortization of life insurance DPAC and VOBA are based upon actuarial assumptions 
regarding future events that are uncertain.  For all products, other than universal life and deferred annuities, 
the most significant of these assumptions is the level of contract persistency and investment yield rates.  
For these products the basis for the amortization of DPAC and VOBA is established at the issue of each 
contract and would only change if our segment’s experience deteriorates to the point that the level of the 
net liability is not adequate.  We do not currently expect that level of deterioration to occur.  For the universal 
life  and  deferred  annuity  products,  amortization  schedules  are  based  upon  the  level  of  historic  and 
anticipated gross profit margins, from the date of each contract’s issued (or purchase, in the case of VOBA).  
These schedules are based upon several actuarial assumptions that are uncertain, are reviewed annually 
and are modified if necessary.  The most significant of these assumptions are claims, investment yield rates 
and contract persistency.  Based upon the most recent actuarial reviews of all of the assumptions, we do 
not currently anticipate material changes to the level of these amortization schedules. 

25 

 
The  property  and  casualty  business  acquisition  costs  consist  of  commissions  net  of  reinsurance 
commissions, during the production of business are deferred and amortized ratably over the terms of the 
policies.  The method used in calculating deferred acquisition costs limits the amount of such deferred costs 
to actual costs or their estimated realizable value, whichever is lower. 

Impairment of Investments 

Impairment of an investment exists if a decline in the estimated fair value is below the amortized cost 
of  the  security.    Management  regularly  monitors  and  evaluates  the  difference  between  the  cost  and 
estimated fair value of fixed maturity investments and other invested assets.  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 Company’s 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 
investment’s  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  our  analysis,  along  with  the  judgment  that  must  be  applied  in  the 
analysis, it is possible that we could reach a different conclusion whether or not to impair a security if we 
had access to additional information about the investee.  Additionally, it is possible that the investee’s ability 
to meet future contractual obligations may be different than what we determined during its analysis, which 
may lead to a different impairment conclusion in future periods.   

If  after  monitoring  and  analyzing  impaired  securities,  management  determines  that  a  decline  in  the 
estimated fair value of any fixed maturity security or other invested asset below cost is other than temporary, 
the carrying amount of the security is reduced to its fair value according to current accounting guidance.  
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. 

Management reviews investment portfolios under our impairment review policy.  Given current market 
conditions and the significant judgments involved, there is a continuing risk that further declines in fair value 
may occur and material other-than-temporary impairments may be recorded in future periods.  Management 
from time to time may sell investments as part of its asset/liability management process or to reposition its 
investment portfolio based on current and expected market conditions.   

During the year ended December 31, 2018, we were not required to recognize an other-than-temporary 
impairment.  During the years ended December 31, 2017 and 2016, we recognized other-than-temporary 
impairments on equity securities amounting to $49 thousand and $1.4 million, respectively.  The impairment 
analysis indicated that, none of the securities whose carrying amount exceeded its estimated fair value was 
considered  other-than-temporarily  impaired  as  of  that  date;  however,  several  factors  are  beyond 
management’s control, such as the following: financial condition of the issuers, movement of interest rates, 
specific situations within corporations, among others.  Over time, the economic and market environment 
may provide additional insight regarding the estimated fair value of certain securities, which could change 
management’s judgment regarding impairment.  This could result in realized losses related to other-than-
temporary declines being charged against future income. 

Our fixed maturity securities are sensitive to interest rate and credit risk fluctuations, which impact the 
fair value of individual securities.  Our equity securities are sensitive to equity price risks, for which potential 
losses could arise from adverse changes in the value of equity securities.  For additional information on the 
sensitivity  of  our  investments,  see  “Quantitative  and  Qualitative  Disclosures  About  Market  Risk”  in  this 
Annual Report. 

26 

 
A  detail  of  the  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 December 31, 2018 and 2017 is included in Note 3, 
Investment in Securities, of the Notes to Consolidated Financial Statements, included in this Annual Report. 

Allowance for Doubtful Receivables 

We  estimate  the  amount  of  uncollectible  receivables  in  each  period  and  establish  an  allowance  for 
doubtful receivables considering, among other things, the continued deterioration of the local economy, the 
exposure to government accounts and the challenging business environment in the Island.  The allowance 
for doubtful receivables amounted to $42.0 million and $35.9 million as of December 31, 2018 and 2017, 
respectively.  As of December 31, 2018 and 2017, the Company had premiums and other receivables of 
$54.3 million and $81.8 million, respectively, from the Government of Puerto Rico, including its agencies, 
municipalities, and public corporations.  The related allowance for doubtful receivables as of December 31, 
2018 and 2017 was $21.0 million and $16.4 million, respectively.  The amount of the allowance is based 
on  the  aging  of  unpaid  accounts,  information  about  the  customer’s  creditworthiness  and  other  relevant 
information.  The estimates of uncollectible accounts are revised each period, and changes are recorded 
in  the  period  they  become  known.    In  determining  the  allowance,  we  use  predetermined  percentages 
applied to aged account balances, as well as individual analysis of large accounts.  These percentages are 
based  on  our  collection  experience  and  are  periodically  evaluated.    A  significant  change  in  the  level  of 
uncollectible accounts would have a material effect on our results of operations. 

In  addition  to  premium-related  receivables,  we  evaluate  the  risk  in  the  realization  of  other  accounts 
receivable, including balances due from third parties related to overpayment of medical claims and rebates, 
among  others.    These  amounts  are  individually  analyzed,  and  the  allowance  determined  based  on  the 
specific collectivity assessment and circumstances of each individual case. 

We  consider  this  allowance  adequate  to  cover  probable  losses  that  may  result  from  our  inability  to 
subsequently collect the amounts reported as accounts receivable.  However, such estimates may change 
significantly in the event that unforeseen economic conditions adversely impact the ability of third parties 
to repay the amounts due to us. 

Goodwill and Other Intangible Assets 

Our consolidated goodwill and other intangible assets at December 31, 2018 were $25.4 million and 
$2.6 million, respectively.   At December 31,  2017 the consolidated goodwill  and other intangible assets 
were $25.4 million and $3.6 million, respectively.  The goodwill and other intangible assets balance for both 
years were primarily related to the acquisition of TSA in 2011.  As of December 31, 2018 and 2017, the 
goodwill related to TSA  was $25.0 million.   As  of December 31, 2018  and 2017  other  intangible  assets 
related to the TSA acquisition were $2.6 million and $3.5 million, respectively.  

We  account  for  goodwill  and  intangible  assets  with  indefinite  lives  in  accordance  with  Accounting 
Standard Codification (ASC) No. 350, Goodwill and Other Intangible Assets, which specifies the types of 
acquired intangible assets that are required to be recognized and reported separately from goodwill.  Under 
this guidance, goodwill is not amortized but is tested for impairment at least annually and more frequently 
if events and circumstances indicate that the asset might be impaired.  An impairment loss is recognized 
to  the  extent  that  the  carrying  amount  exceeds  the  asset’s  fair  value.    For  goodwill,  the  impairment 
determination is made at the reporting unit level and consists of two steps.  

Our  impairment  tests  involve  the  use  of  estimates  related  to  the  fair  value  of  the  reporting  unit  and 
require  a  significant  degree  of  management  judgment  and  the  use  of  subjective  assumptions.    The 
Company assesses qualitative factors to determine whether it is more likely than not that the fair value of a 
reporting unit is less than its carrying amount, including goodwill.  If determined to be necessary, the two-
step impairment test is used to identify potential goodwill impairment and measure the amount of a goodwill 
impairment loss to be recognized (if any).  First, the Company determines the fair value of a reporting unit 
and compares it to its carrying amount.  Second, if the carrying amount of a reporting unit exceeds its fair 
value, an impairment loss is recognized for any excess of the carrying amount of the reporting unit’s goodwill 
over the implied fair value of that goodwill.  The implied fair value of goodwill is determined by allocating 

27 

 
the fair value of the reporting unit in a manner similar to a purchase price allocation.  The residual fair value 
after this allocation is the implied fair value of the reporting unit goodwill. 

Our goodwill impairment test uses the income approach to estimate a reporting unit’s fair value.  Use 
of  the  income  approach  for  our  goodwill  impairment  test  reflects  our  view  that  valuation  methodology 
provides a reasonable estimate of fair value.  The income approach is developed using assumptions about 
future  premiums,  expected  claims,  MLR,  operating  expenses  and  net  income  derived  from  our  internal 
planning  process  and  historical  trends.    The  Company  also  uses  the  market  approach  as  part  of  their 
impairment analysis.  These estimated future cash flows are then discounted. Our assumed discount rate 
is based on our industry’s weighted average cost of capital.  It assumes the effective implementation of 
measures  to  contain  the  utilization  and  cost  trends.    Events  or  changes  in  circumstances,  including  a 
decrease  in  membership,  an  increase  in  MLR  and/or  operating  expenses,  could  result  in  goodwill 
impairment. 

We completed our annual impairment tests of existing goodwill during the fourth quarter of 2018 and 
2017.  Limited interim impairment tests are also performed when potential impairment indicators exist or 
other changes in our business occur.  If we do not achieve our earnings objectives or the cost of capital 
rises  significantly,  the  assumptions  and  estimates  underlying  these  impairment  evaluations  could  be 
adversely  affected  and  result  in  future  impairment  charges  that  would  negatively  impact  our  operating 
results.  On the other hand, since October 2016 the TSA HMO contract scored 4.0 overall on a 5.0 star 
rating  system,  increasing  1.0  versus  the  prior  year,  and  achieved  5  stars  in  Part  D,  which  generated 
additional premiums in 2018.  Furthermore, in October 2018, the TSA HMO product increased its overall 
score  to  4.5  stars  and  the  PPO  contract  increased  its  overall  score  to  4.0  stars,  which  are  expected  to 
further increase Medicare premiums for 2020.  The result of the impairment test performed in 2018 and 
2017 indicated that the fair value of the TSA unit exceeded its carrying value by approximately 62% and 
26%, respectively.   

While we believe we have appropriately allocated the purchase price of our acquisitions, this allocation 
requires  many  assumptions  to  be  made  regarding  the  fair  value  of  assets  and  liabilities  acquired.    In 
addition, estimated fair values developed based on our assumptions and judgments might be significantly 
different if other reasonable assumptions and estimates were to be used.  If estimated fair values are less 
than the carrying values of the reporting unit or if significant impairment indicators are noted relative to other 
intangible assets subject to amortization, we may be required to record impairment losses against future 
income.  

Other Significant Accounting Policies 

We have other accounting policies that are important to an understanding of the consolidated financial 
statements.    See  Note  2,  Significant  Accounting  Policies,  of  the  Notes  to  Consolidated  Financial 
Statements, included in this Annual Report. 

Recently Issued Accounting Standards 

For  a  description  of  our  recently  issued  accounting  standards,  see  Note  2,  Significant  Accounting 

Policies, of the Notes to Consolidated Financial Statements, included in this Annual Report. 

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 in the normal course of business.  We are also subject to additional market risk with respect 
to certain of our financial instruments.  We must effectively manage, measure, and monitor the market risk 
associated  with  our  invested  assets  and  interest  rate  sensitive  liabilities.    We  have  established  and 
implemented comprehensive policies and procedures to minimize the effects of potential market volatility. 

28 

 
 
Market Risk Exposure 

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.  
Analytical tools and monitoring systems are in place to assess each one of the elements of market risks. 

Our investment portfolio consists mainly of investment grade fixed income and a smaller portion is held 
in equity securities and alternative investments. The investment portfolio is conservative, diversified across 
and  within  asset  classes,  and  has  the  following  objectives,  in  order  of  importance:  capital  preservation, 
liquidity,  income  generation  and  capital  appreciation.  The  interest  rate  risk  of  both  our  investments  and 
liabilities is regularly evaluated.  

The  investment  portfolio  is  centrally  managed  by  investment  professionals  and  decisions  are  taken 
based on the guidelines and limitations described in our Investment Policy and the Puerto Rico Insurance 
Code. The Investment Policy is approved by the Board of Directors following the recommendation of the 
Investment  and  Financing  Committee  of  the  Board  of  Directors  (the  “Investment  and  Financing 
Committee”). The Investment and Financing Committee establishes guidelines to ensure the Investment 
Policy is adhered to and any exception must be reported to the Investment and Financing Committee. 

We use a sensitivity analysis to measure the market risk related to our holdings of invested assets and 
other financial instruments.  This analysis estimates the potential changes in fair value of the instruments 
subject to market risk.  This sensitivity analysis is an estimate and should not be viewed as predictive of 
our future financial performance.  Our actual losses in any year could exceed the amounts indicated in the 
following paragraphs.  Limitations related to this sensitivity analysis include: 

• 

• 

the market risk information is limited by the assumptions and parameters established in creating the 
related sensitivity analysis, including the impact of prepayment rates on mortgages; and 
the model assumes that the composition of assets and liabilities remains unchanged throughout the 
year. 

Accordingly, we use such models as tools and not as a substitute for the experience and judgment of 

our management. 

Interest Rate Risk 

Our exposure to interest rate changes results from our significant holdings of fixed maturity securities.  
We  are  also  exposed  to  interest  rate  risk  from  our  variable  interest  secured  term  loan  and  from  our 
policyholder deposits. 

Equity Price Risk 

Our investments in equity securities expose us to price risks, for which potential losses could arise from 

adverse changes in the value of these investments. 

29 

 
 
 
Risk Measurement 

Our investment securities are a source of market risk.  As of December 31, 2018 approximately 77% 
of our investment portfolio consisted of fixed maturity securities.  The remaining balance is comprised of 
equity securities and alternative investments.  Our fixed maturity securities classified as available-for-sale 
and alternative investments are recorded at fair value and changes in the fair value of these securities, net 
of the related tax effect, are excluded from operations and are reported as a separate component of other 
comprehensive  income  (loss)  until  realized.    Fixed  maturity  securities  classified  as  held-to-maturity  are 
recorded at amortized cost and adjusted for the amortization or accretion of premiums or discounts.  Equity 
securities are recorded at fair value and changes in fair value are included in earnings.  The fair value of 
the investments in our available-for-sale and held-to-maturity portfolios is exposed to both interest rate risk 
and equity price risk. 

Interest Rate Risk 

We have evaluated the net impact to the fair value of our fixed income investments of a significant one-

time change in interest rate risk using a combination of both statistical and fundamental methodologies.  
From  these  shocked  values,  a  resultant  market  price  appreciation/depreciation  can  be  determined  after 
portfolio  cash  flows  are  modeled  and  evaluated  over  instantaneous  100,  200,  and  300  basis  point  rate 
shifts.  Techniques used in the evaluation of cash flows include Monte Carlo simulation through a series of 
probability distributions over 200 interest rate paths.  Necessary prepayment speeds are compiled using 
Yield  Book,  which  sources  numerous  factors  in  deriving  speeds,  including  but  not  limited  to:  historical 
speeds,  economic  indicators,  street  consensus  speeds,  etc.    Securities  evaluated  by  us  under  these 
scenarios  include  mortgage  pass-through  certificates  and  collateralized  mortgage  obligations  of  U.S. 
agencies, and private label structures, if cash flows information is available.  The following table sets forth 
the result of this analysis for the years ended December 31, 2018 and 2017.  The analysis does not consider 
any action that management can take to mitigate the impact of changes in market rates. 

(Dollar amounts in millions)

Change in Interest Rates

Expected
Fair Value

Amount of 
Decrease

% 
Change

December 31, 2018:

Base Scenario
+100 bp
+200 bp
+300 bp

December 31, 2017:

Base Scenario
+100 bp
+200 bp
+300 bp

$  

1,202.0
1,148.2
1,097.9
1,049.4

$  

1,219.3
1,163.4
1,111.7
1,062.4

(53.8)
(104.1)
(152.6)

(55.9)
(107.6)
(156.9)

(4.5)%
(8.7)%
(12.7)%

(4.6)%
(8.9)%
(13.0)%

We believe that an interest rate shift in a 12-month period of 100 basis points represents a moderately 
adverse outcome, while a 200 basis point shift is significantly adverse and a 300 basis point shift is less 
likely given historical precedents.  Although we classify 99.8% of our fixed maturity securities as available-
for-sale, our cash flows and the intermediate duration of our investment portfolio should allow us to hold 
securities until maturity, thereby avoiding the recognition of losses, should interest rates rise significantly. 

Equity Price Risk 

Our  equity  securities  are  composed  of  mutual  funds  whose  underlying  assets  are  comprised  of 
domestic equity securities, domestic preferred equity securities, international equity securities and higher 
risk fixed income instruments. The fixed income mutual funds invest mainly in loan participations and high 
yield debt.  The securities in these funds are issued by corporations, financial institutions and governmental 

30 

 
 
    
         
    
        
    
        
    
         
    
        
    
        
entities  that  are  either  unrated  or  have  non-investment  grade  ratings  from  either  Standard  &  Poor’s  or 
Moody’s.   

Our investments in mutual funds exposes us to equity price risk and credit risk.  We manage these 

exposures by closely monitoring the performance of these mutual funds. 

Assuming an immediate decrease of 10% in the market value of our equity securities as of December 
31,  2018  and  2017,  the  hypothetical  loss  in  the  fair  value  of  these  investments  would  have  been 
approximately $27.9 million and $34.2 million, respectively. 

Alternative Price Risk 

Our alternative investments in the available-for-sale portfolio are comprised of commitments to limited 
liability partnerships.  These private funds call capital over time and invest in various asset classes such as 
traditional private equity, infrastructure equity, real estate debt and corporate debt.  These investments are 
unrated,  illiquid and  expose us to a  variety of underlying risks. We manage these exposures by closely 
monitoring the performance of these funds.  The fair value of alternative investments is estimated using the 
net  asset  value  of  the  Company’s  ownership  interest  in  the  partnerships  as  a  practical  expedient  to 
determining an independent fair value. 

Assuming an immediate decrease of 10% in the market value of our equity securities as of December 
31,  2018  and  2017,  the  hypothetical  loss  in  the  fair  value  of  these  investments  would  have  been 
approximately $7.4 million and $3.5 million, respectively. 

Other Risk Measurement 

We  are  subject  to  interest  rate  risk  on  our  variable  interest  secured  term  loan  and  our  policyholder 
deposits.  Shifting interest rates do not have a material effect on the fair value of these instruments.  The 
secured term loan has a variable interest rate structure, which reduces the potential exposure to interest 
rate  risk.    The  policyholder  deposits  have  short-term  interest  rate  guarantees,  which  also  reduce  the 
accounts’ exposure to interest rate risk. 

31 

 
 
 
Triple-S Management Corporation and 
Subsidiaries  
 Consolidated Financial Statements 
 December 31, 2018, 2017, and 2016

32 

 
 
REPORT OF INDEPENDENT REGISTERED PUBLIC ACCOUNTING FIRM  

To the Stockholders and the Board of Directors of Triple-S Management Corporation 

Opinion on Internal Control over Financial Reporting  

Deloitte & Touche LLP 

Torre Chardon 
350 Chardon Ave., Ste. 700 
San Juan, PR 00918-2140 
USA 
Tel:   +1 787 759 7171   
www.deloitte.com 

We have audited the internal control over financial reporting of Triple-S Management Corporation and its 
subsidiaries (the “Company”) as of December 31, 2018, based on criteria established in Internal Control — 
Integrated Framework (2013) issued by the Committee of Sponsoring Organizations of the Treadway 
Commission (COSO). In our opinion, the Company maintained, in all material respects, effective internal 
control over financial reporting as of December 31, 2018, based on criteria established in Internal Control — 
Integrated Framework (2013) issued by COSO. 

We have also audited, in accordance with the standards of the Public Company Accounting Oversight Board 
(United States) (PCAOB), the consolidated financial statements as of and for the year ended December 31, 
2018, of the Company and our report dated February 28, 2019, expressed an unqualified opinion on those 
financial statements. 

Basis for Opinion  

The Company’s management is responsible for maintaining effective internal control over financial reporting 
and for its assessment of the effectiveness of internal control over financial reporting, included in the 
accompanying Management Report on Internal Control over Financial Reporting. Our responsibility is to 
express an opinion on the Company’s internal control over financial reporting based on our audit. We are a 
public accounting firm registered with the PCAOB and are required to be independent with respect to the 
Company in accordance with the U.S. federal securities laws and the applicable rules and regulations of the 
Securities and Exchange Commission and the PCAOB. 

We conducted our audit in accordance with the standards of the PCAOB. Those standards require that we 
plan and perform the audit to obtain reasonable assurance about whether effective internal control over 
financial reporting was maintained in all material respects. Our audit included obtaining an understanding of 
internal control over financial reporting, assessing the risk that a material weakness exists, testing and 
evaluating the design and operating effectiveness of internal control based on the assessed risk, and 
performing such other procedures as we considered necessary in the circumstances. We believe that our 
audit provides a reasonable basis for our opinion. 

Definition and Limitations of Internal Control over Financial Reporting 

A company’s internal control over financial reporting is a process designed to provide reasonable assurance 
regarding the reliability of financial reporting and the preparation of financial statements for external 
purposes in accordance with generally accepted accounting principles. A company’s internal control over 
financial reporting includes those policies and procedures that (1) pertain to the maintenance of records 
that, in reasonable detail, accurately and fairly reflect the transactions and dispositions of the assets of the 
company; (2) provide reasonable assurance that transactions are recorded as necessary to permit 
preparation of financial statements in accordance with generally accepted accounting principles, and that 
receipts and expenditures of the company are being made only in accordance with authorizations of 
management and directors of the company; and (3) provide reasonable assurance regarding prevention or 
timely detection of unauthorized acquisition, use, or disposition of the company’s assets that could have a 
material effect on the financial statements. 

Because of its inherent limitations, internal control over financial reporting may not prevent or detect 
misstatements. Also, projections of any evaluation of effectiveness to future periods are subject to the risk 
that controls may become inadequate because of changes in conditions, or that the degree of compliance 
with the policies or procedures may deteriorate.  

February 28, 2019 
Stamp No. E360679 
affixed to original. 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
REPORT OF INDEPENDENT REGISTERED PUBLIC ACCOUNTING FIRM 

To the Stockholders and the Board of Directors of Triple-S Management Corporation 

Opinion on the Financial Statements 

Deloitte & Touche LLP 

Torre Chardon 
350 Chardon Ave., Ste. 700 
San Juan, PR 00918-2140 
USA 
Tel:   +1 787 759 7171   
www.deloitte.com 

We have audited the accompanying consolidated balance sheets of Triple-S Management Corporation and its 
subsidiaries (the "Company") as of December 31, 2018 and 2017, the related consolidated statements of 
earnings, comprehensive income, stockholders' equity, and cash flows, for each of the three years in the 
period ended December 31, 2018, and the related notes (collectively referred to as the "consolidated 
financial statements"). In our opinion, the consolidated financial statements present fairly, in all material 
respects, the financial position of the Company as of December 31, 2018 and 2017, and the results of its 
operations and its cash flows for each of the three years in the period ended December 31, 2018, in 
conformity with accounting principles generally accepted in the United States of America. 

We have also audited, in accordance with the standards of the Public Company Accounting Oversight Board 
(United States) (PCAOB), the Company's internal control over financial reporting as of December 31, 2018, 
based on criteria established in Internal Control — Integrated Framework (2013) issued by the Committee of 
Sponsoring Organizations of the Treadway Commission and our report dated February 28, 2019, expressed 
an unqualified opinion on the Company's internal control over financial reporting.  

Change in Accounting Principle 

As discussed in Note 2 to the financial statements, the Company has changed its method of accounting for 
unrealized holding gains and losses on equity investments in 2018 due to the adoption of Financial 
Accounting Standards Board Accounting Standards Update 2016-01, Recognition and measurement of 
financial assets and financial liabilities. 

Basis for Opinion  

These consolidated financial statements are the responsibility of the Company's management. Our 
responsibility is to express an opinion on the Company's financial statements based on our audits. We are a 
public accounting firm registered with the PCAOB and are required to be independent with respect to the 
Company in accordance with the U.S. federal securities laws and the applicable rules and regulations of the 
Securities and Exchange Commission and the PCAOB. 

We conducted our audits in accordance with the standards of the PCAOB. Those standards require that we 
plan and perform the audit to obtain reasonable assurance about whether the financial statements are free 
of material misstatement, whether due to error or fraud. Our audits included performing procedures to 
assess the risks of material misstatement of the financial statements, whether due to error or fraud, and 
performing procedures that respond to those risks. Such procedures included examining, on a test basis, 
evidence regarding the amounts and disclosures in the financial statements. Our audits also included 
evaluating the accounting principles used and significant estimates made by management, as well as 
evaluating the overall presentation of the financial statements. We believe that our audits provide a 
reasonable basis for our opinion. 

February 28, 2019 
Stamp No. E360678 
affixed to original. 

We have served as the Company's auditor since 2015. 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Triple-S Management Corporation and Subsidiaries  
Consolidated Balance Sheets 
December 31, 2018 and 2017 
(dollar amounts in thousands, except share data) 

Assets
Investments and cash

Fixed maturities available for sale, at fair value

2018

2017

(amortized cost of $1,168,369 in 2018 and $1,171,651 in 2017)

$         

1,199,402

$         

1,216,788

Fixed maturities held to maturity, at amortized cost

(fair value of $2,619 in 2018 and $2,475 in 2017)

Equity investments, at fair value

(cost of $265,858 in 2018 and $292,459 in 2017)

Other invested assets, at net asset value

(amortized cost of $72,627 in 2018 and $34,670 in 2017)

Policy loans
Cash and cash equivalents

2,492

2,319

279,164

342,308

74,015
9,469
117,544

34,985
9,077
198,941

Total investments and cash

1,682,086

1,804,418

Premium and other receivables, net
Deferred policy acquisition costs and value of business acquired
Property and equipment, net
Deferred tax asset
Goodwill
Other assets

Total assets

628,444
215,159
81,923
79,010
25,397
48,229
2,760,248

$         

899,327
200,788
74,716
65,123
25,397
46,996
3,116,765

$         

Liabilities and Stockholders’ Equity
Claim liabilities
Liability for future policy benefits
Unearned premiums
Policyholder deposits
Liability to Federal Employees’ Health Benefits and

Federal Employees' Programs

Accounts payable and accrued liabilities
Deferred tax liability
Long term borrowings
Liability for pension benefits

Total liabilities

Commitments and contingencies

Stockholders’ equity

$           

936,789
361,495
82,990
174,110

44,926
275,228
3,245
28,883
31,274
1,938,940

1,106,876
339,507
86,349
176,534

52,287
354,894
21,891
32,073
33,672
2,204,083

Triple-S Management Corporation stockholders' equity
Common stock Class A, $1 par value. Authorized
100,000,000 shares; issued and outstanding
950,968 at December 31, 2018 and 2017

Common stock Class B, $1 par value. Authorized 100,000,000 
shares; issued and outstanding 21,980,492 and 22,627,077
shares at December 31, 2018 and 2017, respectively

Additional paid-in capital
Retained earnings
Accumulated other comprehensive income, net

Total Triple-S Management Corporation stockholders' equity

Non-controlling interest in consolidated subsidiary

Total stockholders' equity

951

951

21,980
34,021
761,970
3,062
821,984

(676)

821,308

22,627
53,142
785,390
51,254
913,364

(682)

912,682

Total liabilities and stockholders’ equity

$         

2,760,248

$         

3,116,765

The accompanying notes are an integral part of these financial statements.

36 

              
                
                
                
                
              
                
              
                
              
                  
                
                
                
              
                  
Triple-S Management Corporation and Subsidiaries  
Consolidated Statements of Earnings 
December 31, 2018, 2017, and 2016 
(dollar amounts in thousands, except per share data) 

Revenues:
Premiums earned, net
Administrative service fees
Net investment income
Other operating revenues

2018

2017

2016

$      

2,938,591
14,701
61,909
5,794

$       

2,826,932
16,514
51,615
3,660

$       

2,890,641
17,843
48,913
3,461

Total operating revenues

3,020,995

2,898,721

2,960,858

Net realized investment gains (losses):

Total other-than-temporary impairment losses on securities
Net realized gains, excluding other-than-temporary impairment

losses on securities

Total net realized investment gains

Net unrealized investment losses on equity investments

Other income, net

Total revenues

Benefits and expenses:
Claims incurred, net of reinsurance 
Operating expenses

Total operating costs

Interest expense

Total benefits and expenses

(Loss) income before taxes

Income tax (benefit) expense 

Net (loss) income

Less: Net loss attributable to non-controlling interest

-

298

298

(36,546)

11,312

(49)

(1,434)

10,880

10,831

-

6,533

18,813

17,379

-

6,569

2,996,059

2,916,085

2,984,806

2,527,613
554,715

3,082,328
6,903

2,353,101
477,213

2,830,314
6,794

2,472,191
493,894

2,966,085
7,635

3,089,231

2,837,108

2,973,720

(93,172)

(29,866)

(63,306)

4

78,977

24,496

54,481

5

11,086

(6,345)

17,431

7

Net (loss) income attributable to Triple-S Management Corporation

$          

(63,302)

$           

54,486

$           

17,438

Earnings per share attributable to Triple-S Management Corporation

Basic net (loss) income per share

Diluted net (loss) income per share

$              

(2.76)

$               

2.27

$               

0.71

$              

(2.76)

$               

2.26

$               

0.71

The accompanying notes are an integral part of these financial statements.

37 

 
            
Triple-S Management Corporation and Subsidiaries  
Consolidated Statements of Comprehensive Income 
December 31, 2018, 2017, and 2016 
(dollar amounts in thousands) 

Net (loss) income

Other comprehensive (loss) income, net of tax:

Net unrealized change in fair value of available for sale securities, net of taxes
Defined benefit pension plan:
Actuarial gain (loss), net
Prior service credit, net

Total other comprehensive income, net of tax

Comprehensive (loss) income

Comprehensive loss attributable to non-controlling interest

Comprehensive (loss) income attributable to Triple-S Management Corporation

2018

2017

2016

$       

(63,306)

$        

54,481

$     

17,431

(9,048)

13,867

(107)

738
-
(8,310)
(71,616)
4
(71,612)

$       

(5,028)
20
8,859
63,340
5
63,345

$        

18,232
(1,353)
16,772
34,203
7
34,210

$     

The accompanying notes are an integral part of these financial statements.

38 

 
          
         
          
 
              
          
       
 
                  
                
       
          
           
       
        
         
       
                 
                 
               
Triple-S Management Corporation and Subsidiaries  
Consolidated Statements of Stockholders’ Equity 
December 31, 2018, 2017, and 2016 
(dollar amounts in thousands) 

Triple-S

Class A
Com m on
Stock

Class B
Com m on
Stock

Additional
Paid-in
Capital

Retained
Earnings

Accum ulated
Other
Com prehensive
Incom e (Loss)

Managem ent Non-controlling 
Corporation

Interest in 
Stockholders’ Consolidated  Stockholders’
Subsidiary

Equity

Equity

Total

Balance, Decem ber 31, 2015

$         

951

$      

24,048

$       

83,438

$      

713,466

$                

25,623

$         

847,526

$              

(670)

$         

846,856

Share-based compensation

Stock issued upon exercise of stock options

Repurchase and retirement of common stock

Comprehensive income (loss)

-

-

-

-

223

4

2,576

51

(954)

(20,473)

-

-

-

-

-

-

-

-

17,438

16,772

2,799

55

(21,427)

34,210

-

-

-

(7)

2,799

55

(21,427)

34,203

Balance, Decem ber 31, 2016

$         

951

$      

23,321

$       

65,592

$      

730,904

$                

42,395

$         

863,163

$              

(677)

$         

862,486

Share-based compensation

Repurchase and retirement of common stock

Comprehensive income (loss)

-

-

-

167

(861)

-

6,909

(19,359)

-

-

-

-

-

54,486

8,859

7,076

(20,220)

63,345

-

-

(5)

7,076

(20,220)

63,340

Balance, Decem ber 31, 2017

$         

951

$      

22,627

$       

53,142

$      

785,390

$                

51,254

$         

913,364

$              

(682)

$         

912,682

Share-based compensation

Repurchase and retirement of common stock

Comprehensive income (loss)

Cumulative effect adjustment due to

implementation of ASU 2016-01

-

-

-

-

-

-

-

-

287

(934)

3,070

(22,191)

-

-

-

-

(63,302)

(8,310)

3,357

(23,125)

(71,612)

39,882

(39,882)

-

-

-

6

-

3,357

(23,125)

(71,606)

-

Balance, Decem ber 31, 2018

$         

951

$      

21,980

$       

34,021

$      

761,970

$                  

3,062

$         

821,984

$              

(676)

$         

821,308

The accompanying notes are an integral part of these financial statements.

39 

 
 
 
  
Triple-S Management Corporation and Subsidiaries  
Consolidated Statements of Cash Flows 
December 31, 2018, 2017, and 2016 
(dollar amounts in thousands) 

Cash flows from operating activities
Net (loss) income
Adjustments to reconcile net income to net cash

provided by operating activities

Depreciation and amortization
Net amortization of investments
Additions to the allowance for doubtful receivables
Deferred tax benefit
Net realized investment gains on sale of securities
Net unrealized loss on equity investments
Interest credited to policyholder deposits
Share-based compensation

(Increase) decrease in assets

Premium and other receivables, net
Deferred policy acquisition costs and value of

business acquired

Deferred taxes
Other assets

Increase (decrease) in liabilities

Claim liabilities
Liability for future policy benefits
Unearned premiums
Liability to FEHBP
Accounts payable and accrued liabilities

Net cash provided by operating activities

2018

2017

2016

$          

(63,306)

$            

54,481

$            

17,431

13,535
3,976
11,321
(32,078)
(298)
36,546
5,722
3,357

13,198
10,114
1,462
(9,916)
(10,831)
-
5,677
7,076

14,120
8,671
1,601
(8,326)
(17,379)
-
3,794
2,463

259,561

(614,424)

(5,320)

(12,258)
946
(1,470)

(170,087)
21,988
(3,359)
(7,361)
(59,276)
7,459

(6,596)
4,946
5,117

618,933
18,275
7,039
17,917
166,450
288,918

(7,286)
(4,799)
(9,009)

(3,822)
31,702
(950)
7,675
(24,095)
6,471

The accompanying notes are an integral part of these financial statements.

40 

 
 
 
 
Triple-S Management Corporation and Subsidiaries  
Consolidated Statements of Cash Flows 
December 31, 2018, 2017, and 2016 
(dollar amounts in thousands) 

Cash flows from investing activities
Proceeds from investments sold or matured

Securities available for sale:
Fixed maturities sold
Fixed maturities matured

Securities held to maturity:

Fixed maturities matured

Equity investments sold
Other invested assets sold

Acquisition of investments

Securities available for sale

Fixed maturities

Securities held to maturity

Fixed maturities
Equity investments
Other invested assets
Other investments

Net disbursements for policy loans
Net capital expenditures

2018

2017

2016

$      

1,302,810
24,945

$         

463,232
18,893

$         

400,848
56,988

8,182
203,841
3,714

2,712
59,963
-

1,538
109,049
-

(1,343,346)

(560,304)

(482,252)

(8,356)
(156,486)
(47,221)
(705)
(392)
(19,840)

(2,197)
(134,834)
-
(2,064)
(513)
(21,359)

(1,445)
(163,119)
-
(2,493)
(663)
(4,750)

Net cash used in investing activities

(32,854)

(176,471)

(86,299)

Cash flows from financing activities
Change in outstanding checks in excess of bank balances
Repayments of long-term borrowings
Repurchase and retirement of common stock
Net proceeds from revolving line of credit
Proceeds from policyholder deposits
Surrenders of policyholder deposits

Net cash used in financing activities

Net (decrease) increase in cash and cash equivalents

Cash and cash equivalents
Beginning of year

End of year

(22,243)
(3,236)
(22,377)
-
18,531
(26,677)

(56,002)

(81,397)

12,683
(2,836)
(20,220)
1,964
13,557
(22,082)

(16,934)

95,513

12,250
(1,742)
(21,371)
-
18,224
(21,923)

(14,562)

(94,390)

198,941

103,428

197,818

$         

117,544

$         

198,941

$         

103,428

The accompanying notes are an integral part of these financial statements.

41 

 
 
 
 
Triple-S Management Corporation and Subsidiaries  
Notes to Consolidated Financial Statements 
December 31, 2018, 2017, and 2016 
(dollar amounts in thousands) 

1. 

Nature of Business 

Triple-S Management Corporation (the Corporation, the Company or TSM) was incorporated under 
the  laws  of  the  Commonwealth  of  Puerto  Rico  to  engage,  among  other  things,  as  the  holding 
company of entities primarily involved in the insurance industry. 

The Company has the following wholly owned subsidiaries: (1) Triple-S Salud, Inc. (TSS) and Triple-
S Advantage, Inc. (TSA), are managed care organizations that provide health benefits services to 
subscribers  through  contracts  with  hospitals,  physicians,  dentists,  laboratories,  and  other 
organizations;  (2) Triple-S  Vida,  Inc.  (TSV)  and  Triple-S  Blue,  Inc.  (TSB),  are  engaged  in  the 
underwriting  of  life  and  accident  and  health  insurance  policies  and  the  administration  of  annuity 
contracts; and (3)  Triple-S Propiedad, Inc. (TSP), is engaged  in the underwriting of property and 
casualty insurance policies.  The Company, TSS and TSA are members of the Blue Cross and Blue 
Shield  Association  (BCBSA).  The  Company  and  the  above  mentioned  subsidiaries  are  subject 
directly or indirectly to the regulations of the Commissioner of Insurance of the Commonwealth of 
Puerto Rico (the Commissioner of Insurance), the General Superintendence of Insurance of Costa 
Rica, the U.S. Virgin Islands (USVI), the British Virgin Islands (BVI) Financial Services Commission, 
and the Anguilla Financial Services Commission. 

The Company also owns a controlling interest in a health clinic in Puerto Rico, as part of our strategic 
initiatives.  Besides its current operations, this health clinic owns controlling interests in other health 
clinics throughout the island. 

Through our subsidiary TSS,  we provide services to  participants of the Commonwealth of Puerto 
Rico Health Insurance Plan (similar to Medicaid) (Medicaid).  On September 21, 2018, TSS entered 
into a contract with the Puerto Rico Health Insurance Administration (ASES by its Spanish acronym), 
as one of the five managed care organizations (MCOs), that offer health care services to Medicaid 
and Child Health Insurance subscribers for the government of Puerto Rico’s revised Medicaid health 
insurance program.  The contract is effective from November 1, 2018 up to September 30, 2021, 
which  term  may  be  extended  an  additional  year  at  ASES’s  option.    The  revised  delivery  model 
requires MCOs to serve subscribers in an island-wide basis, rather than through the assignment of 
specific regions within the Island.  Under the new agreement, TSS is responsible for the provision of 
medical, mental, pharmacy, and dental healthcare services on an at-risk basis to subscribers who 
enroll with TSS.  ASES will pay TSS a per member per month rate that will vary depending on the 
clinical  condition  or  category  of  the  subscriber  and  initially  assigned  TSS  approximately  280,000 
subscribers across the Island.  Since April 1, 2015 up to the effective date of the new contract, TSS 
provided medical, mental, pharmacy and dental healthcare services to Medicaid subscribers in the 
Metro-North and West regions of the government of Puerto Rico’s health insurance program, which 
included approximately 400,000 subscribers, on an at-risk basis.  

A  substantial  majority  of  the  Company’s  business  activity  is  within  Puerto  Rico,  and  as  such,  the 
Company is subject to the risks associated with the Puerto Rico economy. 

42 

 
 
 
Triple-S Management Corporation and Subsidiaries  
Notes to Consolidated Financial Statements 
December 31, 2018, 2017, and 2016 
(dollar amounts in thousands) 

2. 

Significant Accounting Policies 

The following are the significant accounting policies followed by the Company and its subsidiaries: 

Basis of Presentation 
The  accompanying  consolidated  financial  statements  have  been  prepared  in  conformity  with 
accounting principles generally accepted in the United States of America (GAAP).  The consolidated 
financial  statements  include  the  financial  statements  of  the  Company  and  its  subsidiaries.  
Intercompany balances and transactions have been eliminated in consolidation. 

Use of Estimates 
The  preparation  of  the  consolidated  financial  statements  in  conformity  with  GAAP  requires  the 
Company to make a number of estimates and assumptions relating to the reported amounts of assets 
and liabilities and the disclosure of contingent assets and liabilities at the date of the consolidated 
financial statements, and the reported amounts of revenue and expenses during the period.  Actual 
results could differ from those estimates. 

Cash Equivalents 
The Company considers all highly liquid debt instruments with maturities of three months or less at 
the  date  of  acquisition  to  be  cash  equivalents.    Cash  and  cash  equivalents  are  recorded  at  cost, 
which approximates fair value.   Cash equivalents of $49,233 and $87,572  at December 31, 2018 
and  2017,  respectively,  consist  principally  of money  market funds  and  certificates  of  deposit  with 
original maturities of three months or less.   

Investments 

Fixed maturities 
Investment  in  debt  securities  at  December  31,  2018  and  2017  consists  mainly  of  obligations  of 
government-sponsored  enterprises,  U.S. Treasury  securities  and  obligations  of  U.S. government 
instrumentalities, obligations of the Commonwealth of Puerto Rico and its instrumentalities, municipal 
securities,  corporate  bonds,  residential  mortgage-backed  securities,  and  collateralized  mortgage 
obligations.  The Company classifies its debt securities in one of two categories: available-for-sale or 
held-to-maturity.  Securities classified as held-to-maturity are those securities in which the Company 
has the ability and intent to hold until maturity.  All other securities not included in held-to-maturity are 
classified as available-for-sale. 

Available-for-sale  securities  are  recorded  at  fair  value.    The  fair  values  of  debt  securities  (both 
available-for-sale and held-to-maturity investments) are based on quoted market prices for those or 
similar investments at the reporting date.  Held-to-maturity debt securities are recorded at amortized 
cost, adjusted for the amortization or accretion of premiums and discounts, respectively.  Unrealized 
holding gains and losses, net of the related tax effect, on available-for-sale securities are excluded 
from  earnings  and  are  reported  as  a  separate  component  of  other  comprehensive  income  until 
realized.    Realized  gains  and  losses  from  the  sale  of  available-for-sale  securities  are  included  in 
earnings and are determined on a specific-identification basis. 

Transfers  of  securities  between  categories  are  recorded  at  fair  value  at  the  date  of  transfer.  
Unrealized  holding  gains  or  losses  associated  with  transfers  of  securities  from  held-to-maturity  to 
available-for-sale  are  recorded  as  a  separate  component  of  other  comprehensive  income.    The 
unrealized  holding  gains  or  losses  included  in  the  separate  component  of  other  comprehensive 
income  for  securities  transferred  from  available-for-sale  to  held-to-maturity,  are  maintained  and 

43 

 
Triple-S Management Corporation and Subsidiaries  
Notes to Consolidated Financial Statements 
December 31, 2018, 2017, and 2016 
(dollar amounts in thousands) 

amortized into earnings over the remaining life of the security as an adjustment to yield in a manner 
consistent with the amortization or accretion of premium or discount on the associated security. 

If a fixed maturity security is in an unrealized loss position and the Company has the intent to sell the 
fixed maturity security, or it is more likely than not that the Company will have to sell the fixed maturity 
security before recovery of its amortized cost basis, the decline in value is deemed to be other-than-
temporary and is recorded to other-than-temporary impairment losses recognized in earnings in the 
Company’s  consolidated  statements  of  earnings.    For  impaired  fixed  maturity  securities  that  the 
Company does not intend to sell or it is more likely than not that such securities will not have to be 
sold, but the Company expects not to fully recover the amortized cost basis, the credit component of 
the  other-than-temporary  impairment  is  recognized  in  other-than-temporary  impairment  losses 
recognized  in  earnings  in  the  Company’s  consolidated  statements  of  earnings  and  the  non-credit 
component of the other-than-temporary impairment is recognized in other comprehensive income.  
Furthermore, unrealized losses entirely caused by non-credit related factors related to fixed maturity 
securities for which the Company expects to fully recover the amortized cost basis continue to be 
recognized in accumulated other comprehensive income. 

The credit component of an other-than-temporary  impairment is determined by  comparing the net 
present  value  of  projected  future  cash  flows  with  the  amortized  cost  basis  of  the  fixed  maturity 
security. The net present value is calculated by discounting the Company’s best estimate of projected 
future  cash  flows  at  the  effective  interest  rate  implicit  in  the  fixed  maturity  security  at  the  date  of 
acquisition.  

A  decline  in  the  fair  value  of  any  available-for-sale  or  held-to-maturity  security  below  cost  that  is 
deemed to be other-than-temporary results in an impairment to reduce the carrying amount to fair 
value.  The impairment is charged to earnings and a new cost basis for the security is established.  
To determine whether an impairment is other-than-temporary, the Company considers whether it has 
the  ability  and  intent  to  hold  the  investment  until  a  market  price  recovery  and  considers  whether 
evidence  indicating  the  cost  of  the  investment  is  recoverable  outweighs  evidence  to  the  contrary.  
Evidence considered in this assessment includes the reasons for the impairment, the severity and 
duration of the impairment, market conditions, changes in value subsequent to year-end, forecasted 
performance of the investee, and the general market condition in the geographic area or industry the 
investee operates in. 

Premiums  and  discounts  are  amortized  or  accreted  over  the  life  of  the  related  held-to-maturity  or 
available-for-sale security  as an adjustment to  yield  using the effective interest  method.  Dividend 
and interest income are recognized when earned. 

The  Company  regularly  invests  in  mortgaged-backed  securities  and  other  securities  subject  to 
prepayment and call risk.  Significant changes in prevailing interest rates may adversely affect the 
timing and amount of cash flows on such securities.  In addition, the amortization of market premium 
and accretion of market discount for mortgaged-backed securities is based on historical experience 
and  estimates  of  future  payment  speeds  on  the  underlying  mortgage  loans.    Actual  prepayment 
speeds may differ from original estimates and may result in material adjustments to amortization or 
accretion recorded in future periods. 

44 

 
 
 
Triple-S Management Corporation and Subsidiaries  
Notes to Consolidated Financial Statements 
December 31, 2018, 2017, and 2016 
(dollar amounts in thousands) 

Equity investments 
Investment  in  equity  securities  at  December  31,  2018  and  2017  consists  of  mutual  funds  whose 
underlying  assets  are  comprised  of  domestic  equity  securities,  international  equity  securities  and 
higher risk fixed income instruments. Equity investments are recorded at fair value.  The fair values 
of equity investments are mainly based on quoted market prices for those or similar investments at 
the reporting date.  For a specific equity investment, the fair value is estimated using the net asset 
value (NAV) of the Company’s ownership interest in the partnership.  Following the implementation 
on January 1, 2018 of Accounting Standard Update (ASU) 2016-01, Recognition and Measurement 
of  Financial  Assets  and  Financial  Liabilities,  unrealized  holding  gains  and  losses,  on  equity 
investments are included in earnings.  Realized gains and losses from the sale of equity investments 
are included in earnings and are determined on a specific-identification basis. 

Other invested assets 
Other invested assets at December 31, 2018 and 2017 consist mainly of alternative investments in 
partnerships which invest in several private debt and private equity funds.  Portfolios are diversified 
by vintage year, stage, geography, business sectors and number of investments. These investments 
are  not  redeemable  with  the  funds.  Distributions  from  each  fund  are  received  as  the  underlying 
investments of the funds are liquidated. It is estimated that the underlying assets of the funds will be 
liquidated  in  the  next  5  to  12  years.  The  fair  values  of  the  investments  in  this  class  have  been 
estimated using the net asset value (NAV) of the Company’s ownership interest in the partnerships. 
Total  unfunded  capital  commitments  for  these  positions  as  of  December  31,  2018  amounted  to 
$80,484.  The remaining average commitments period is approximately three years.   

Revenue Recognition 

a.  Managed Care 

Subscriber premiums on the managed care business are billed in advance of their respective 
coverage  period  and  the  related  revenue  is  recorded  as  earned  during  the  coverage  period.  
Managed care premiums are billed in the month prior to the effective date of the policy with a 
grace period of up to two months.  If the insured fails to pay, the policy can be cancelled at the 
end of the grace period at the option of the Company. 

Premiums  for  the  Medicaid  business  are  based  on  a  bid  contract  with  ASES  and  billed  in 
advance of coverage period.  Under the risk-based Medicaid contract that expired on October 
31, 2018, there is an excess profit agreement which stipulates that the profit of TSS for each 
fiscal year of the contract term shall not exceed two and a half percentage (2.5%) of the fixed 
amount paid by ASES for each member.  In the event that the profit exceeds this amount, TSS 
and  ASES  shall  share  the  excess  profit  in  proportions  of  fifty  percent  (50%),  subject  to  the 
compliance  by  TSS  with  certain  quality  metrics.    ASES  retains  the  right  to  determine  the 
outcome of the excess profit agreement that is  based on audited financial statements of the 
contracted  services  submitted  annually  by  TSS  and  the  validation  of  the  incurred-but-not-
reported reserve by ASES’s actuary.  We estimate on a monthly basis any estimated amount 
due to ASES and reflect any adjustments to premium revenue in current operations.  As the 
runout of the contract progresses and additional information becomes available, any change in 
the  estimated  accrual  will  be  recorded  in  the  operating  results  of  the  period  in  which  the 
information  becomes  available.    We  report  any  estimated  net  amounts  due  to  ASES  within 
accounts payable and accrued liabilities in the consolidated balance sheets.  As of December 
31, 2018, the Company had accrued an estimated profit sharing due to ASES of $4,294.  There 
was no accrued profit sharing due to ASES as of December 31, 2017. 

45 

 
 
 
Triple-S Management Corporation and Subsidiaries  
Notes to Consolidated Financial Statements 
December 31, 2018, 2017, and 2016 
(dollar amounts in thousands) 

The Medicaid contract that became effective November 1, 2018 includes a minimum medical 
loss ratio (MLR) provision where the Company has to remit to ASES the excess of the target 
MLR  of  92%  over  the  actual  MLR  for  any  given  contract  year  and  would  be  reflected  as  an 
adjustment to premium revenue in current operations.  The target established in the contract 
follows regulation requirements of the Centers for Medicare and Medicaid Services (CMS) for 
Medicaid managed care contracts codified in 42 CFR part 438.  As of December 31, 2018, there 
was no accrued amount due to ASES related to this provision. 

Premiums for the Medicare Advantage (MA) business are based on a bid contract with CMS 
and billed in advance of the coverage period.  We recognize premium revenue in the period in 
which we are obligated to provide services to our members. We record premiums earned but 
not received as premiums receivable and record premiums received in advance of the period of 
service  as  unearned  premiums  in  the  consolidated  balance  sheets.  Unearned  premiums  are 
recognized  as  revenue  throughout  the  related  coverage  period.    MA  contracts  are  renewed 
annually  and  provide  for  a  risk factor  to  adjust  premiums  paid  for  members  that  represent  a 
higher or lower risk to the Company.  Retroactive rate adjustments are made periodically based 
on the aggregate health status and risk scores of the Company’s MA membership.  These risk 
adjustments are evaluated quarterly, based on actuarial estimates.  Actual results could differ 
from these estimates.  We recognize periodic changes to risk-adjusted premiums as revenue 
when the amounts are determinable and collection is reasonably assured, which is possible as 
additional  diagnosis  code  information  is  reported  to  CMS,  when  the  ultimate  settlements  are 
received from CMS, or we receive notification of such settlement amounts.  The data provided 
to CMS to determine members’ risk scores is subject to audit by CMS even after the annual 
settlements occur, which may result in the refund of premiums to CMS.  As additional information 
becomes available,  the recorded estimate  is revised  and reflected in  operating  results  in  the 
period in which it becomes available. 

Prescription drug coverage is offered to Medicare eligible beneficiaries as part of MA plans (MA-
PD).  Premiums are based on a bid contract with CMS that considers the estimated costs of 
providing prescription drug benefits to enrolled participants.  MA-PD premiums are subject to 
adjustment, positive or negative, based upon the application of risk corridors that compare the 
estimated prescription drug costs included in the bids to CMS to actual prescription drug costs.  
Variances exceeding certain thresholds may result in CMS making additional payments or in 
CMS requesting a refund for a portion of the premiums collected.  The Company estimates and 
records  adjustments  to  earned  premiums  related  to  estimated  risk  corridor  payments  based 
upon actual prescription drug costs for each reporting period as if the annual contract were to 
end at the end of each reporting period. 

Administrative  service  fees  include  revenue  from  certain  groups  which  have  managed  care 
contracts that provide for the group to be at risk for all or a portion of their claims experience.  
For these groups, the Company is not at risk and only handles the administration of managed 
care coverage for an administrative service fee.  The Company pays claims under commercial 
self-funded arrangements from its own funds, and subsequently receives reimbursement from 
these  groups.    Claims  paid  under  self-funded  arrangements  are  excluded  from  the  claims 
incurred  in the  accompanying consolidated financial statements.  Administrative  service fees 
under  the  self-funded  arrangements  are  recognized  based  on  the  group’s  membership  or 
incurred claims for the period multiplied by an administrative fee rate plus other fees.  In addition, 
some of these self-funded groups purchase aggregate and/or specific stop-loss coverage.  In 
exchange  for  a  premium,  the  group’s  aggregate  liability  or  the  group’s  liability  on  any  one 
episode of care is capped  for the  year.   Premiums for the stop-loss coverage are actuarially 

46 

 
Triple-S Management Corporation and Subsidiaries  
Notes to Consolidated Financial Statements 
December 31, 2018, 2017, and 2016 
(dollar amounts in thousands) 

determined based on experience and other factors and are recorded as earned over the period 
of the contract in proportion to the coverage provided.  This fully insured portion of premiums is 
included  within  the  premiums  earned,  net  in  the  accompanying  consolidated  statements  of 
earnings. 

b.  Life and Accident and Health Insurance 

Premiums on life insurance policies are billed in advance of their respective coverage period 
and the related revenue is recorded as earned when due.  Premiums on accident and health 
and other short-term policies are recognized as earned primarily on a pro rata basis over the 
contract period.  Premiums on credit life policies are recognized as earned in proportion to the 
amounts  of  insurance  in-force.    Revenues  from  universal  life  and  interest  sensitive  policies 
represent  amounts  assessed  against  policyholders,  including  mortality  charges,  surrender 
charges  actually  paid,  and  earned  policy  service  fees.    The  revenues  for  limited  payment 
contracts are recognized over the period that benefits are provided rather than on collection of 
premiums. 

c.  Property and Casualty Insurance 

Premiums on property and casualty contracts are billed in advance of their respective coverage 
period and they are recognized as earned on a pro rata basis over the policy term.  The portion 
of premiums related to the period prior to the end of coverage is recorded in the consolidated 
balance sheets as unearned premiums and is transferred to premium revenue as earned. 

Allowance for Doubtful Receivables 
The  allowance  for  doubtful  receivables  is  based  on  management’s  evaluation  of  the  aging  of 
accounts  and  such  other  factors  which  deserve  current  recognition,  including  the  continued 
deterioration  of  the  local  economy,  the  exposure  to  government  accounts,  and  the  challenging 
business environment in the island.  This evaluation is performed individually on larger accounts and 
includes  the  use  of  all  available  information  such  as  the  customer’s  credit  worthiness  and  other 
relevant information.  Actual losses could differ from these estimates.  Receivables are charged-off 
against their respective allowance accounts when deemed to be uncollectible. 

Deferred Policy Acquisition Costs and Value of Business Acquired 
Certain  direct  costs  of  acquiring  business  in  the  life  and  accident  and  health,  and  property  and 
casualty segments are deferred by the Company.  Substantially all acquisition costs related to the 
managed care segment are expensed as incurred. 

In the life and accident and health segment, deferred acquisition costs (DAC) consist of commissions 
and certain expenses related to the successful acquisition of the production of life, annuity, accident 
and health, and credit business.  In the event that future premiums, in combination with policyholder 
reserves  and  anticipated  investment  income,  could  not  provide  for  all  future  benefits  and 
maintenance  and  settlement  expenses,  the  amount  of  deferred  policy  acquisition  costs  would  be 
reduced  to  provide  for  such  amount.    The  related  amortization  is  provided  over  the  anticipated 
premium-paying period of the related policies in proportion to the ratio of annual premium revenue 
to expected total premium revenue to be received over the life of the policies.  Interest is considered 
in  the  amortization  of  deferred  policy  acquisition  cost  and  value  of  business  acquired.    For  these 
contracts interest is considered at a level rate at the time of issue of each contract, from 3.90% to 
5.75% for 2018 and 2017, and 5.15% for 2016, and, in the case of the value of business acquired, 
at the time of any acquisition.   

47 

 
Triple-S Management Corporation and Subsidiaries  
Notes to Consolidated Financial Statements 
December 31, 2018, 2017, and 2016 
(dollar amounts in thousands) 

For  certain  other  long-duration  contracts,  deferred  amounts  are  amortized  at  historical  and 
forecasted  credited  interest  rates.    Expected  premium  revenue  is  estimated  by  using  the  same 
mortality  and  withdrawal  assumptions  used  in  computing  liabilities  for  future  policy  benefits.    The 
method followed in computing deferred policy acquisition costs limits the amount of such deferred 
costs  to  their  estimated  net  realizable  value.    In  determining  estimated  net  realizable  value,  the 
computations give effect to the premiums to be earned, related investment income, losses and loss-
adjustment expenses, and certain other costs expected to be incurred as the premium is earned.   

Costs deferred on universal life and interest sensitive products are amortized as a level percentage 
of  the  present  value  of  estimated  gross  profits  from  investment  yields,  mortality,  expenses  and 
surrender charges.  Estimates used are based on the Company’s experience as adjusted to provide 
for  possible  adverse  deviations.    These  estimates  are  periodically  reviewed  and  compared  with 
actual experience.  When it is determined that future expected experience differs significantly from 
that assumed, the estimates are updated for current and future issues which may result in a change 
or release of deferred policy acquisition costs amortization through the consolidated statements of 
earnings. 

The value  assigned to the  life insurance  in-force at  the date of the acquisition  is amortized  using 
methods similar to those used to amortize the deferred policy acquisition costs of the life and accident 
and health segment. 

In the property and casualty segment, acquisition costs consist of commissions incurred during the 
production of business and are deferred and amortized ratably over the terms of the policies. 

Property and Equipment 
Property  and  equipment  are  stated  at  cost.    Maintenance  and  repairs  are  expensed  as  incurred.  
Depreciation is calculated on the straight-line method over the estimated useful lives of the assets.  
Costs of computer equipment, programs, systems, installations, and enhancements are capitalized 
and  amortized  straight-line  over  their  estimated  useful  lives.    The  following  is  a  summary  of  the 
estimated useful lives of the Company’s property and equipment: 

Asset Category

Buildings
Building improvements
Leasehold improvements
Office furniture
Computer software
Computer equipment, equipment,
and automobiles

Estimated
Useful Life

20 to 50 years
3 to 10 years
10 years
7 years
3 to 5 years

3 to 5years

Long-Lived Assets, including Goodwill 
Long-lived  assets,  such  as  property  and  equipment,  and  purchased  intangible  assets  subject  to 
amortization, are reviewed for impairment whenever  events or changes in circumstances indicate 
that the carrying amount of an asset may not be recoverable.  Recoverability of assets to be held 
and used is measured by a comparison of the carrying amount of an asset to estimated undiscounted 
future cash flows expected to be generated by the asset.  If the carrying amount of an asset exceeds 
its  estimated  future  cash  flows,  an  impairment  charge  is  recognized  by  the  amount  by  which  the 

48 

 
  
Triple-S Management Corporation and Subsidiaries  
Notes to Consolidated Financial Statements 
December 31, 2018, 2017, and 2016 
(dollar amounts in thousands) 

carrying  amount  of  the  asset  exceeds  the  fair  value  of  the  asset.    The  assets  and  liabilities  of  a 
disposal group classified as held for sale would be presented separately in the appropriate asset and 
liability sections of the consolidated balance sheets.  During 2018, 2017 and 2016, impairment tests 
on  intangible  assets  were  performed  and  based  on  the  results  of  the  tests  no  impairment  was 
recorded.    

Goodwill  and  intangible  assets  that  have  indefinite  useful  lives  are  tested  at  least  annually  for 
impairment, and are tested for impairment more frequently if events or circumstances indicate that 
the asset might be impaired.  An impairment loss is recognized to the extent that the carrying amount 
exceeds the asset’s fair value.  For goodwill, the impairment determination is made at the reporting 
unit level.  The Company may perform a qualitative analysis under certain circumstances, or perform 
a two-step quantitative analysis.  In the qualitative analysis, the Company determines if it is more 
likely  than not that the fair  value  of a reporting unit  is less than its carrying amount by  assessing 
current events and circumstances. If there are factors present indicating potential impairment, the 
Company would proceed to the two-step quantitative analysis.  The two-step impairment test is used 
to identify potential goodwill impairment and measure the amount of a goodwill impairment loss to 
be recognized (if any).   First, the Company determines the fair value of a reporting unit and compares 
it to its carrying amount.  Second, if the carrying amount of a reporting unit exceeds its fair value, an 
impairment loss is recognized for any excess of the carrying amount of the reporting unit’s goodwill 
over  the  implied  fair  value  of  that  goodwill.    The  implied  fair  value  of  goodwill  is  determined  by 
allocating the fair value of the reporting unit in a manner similar to a purchase price allocation.  The 
residual fair value after this allocation is the implied fair value of the reporting unit goodwill.   

The annual impairment test is based on an evaluation of estimated future discounted cash flows. 
The Company also uses the market approach as part of their impairment analysis.  The estimated 
discounted  cash  flows  are  based  on  the  best  information  available,  including  supportable 
assumptions and projections we believe are reasonable. Our discounted cash flow estimates use 
discount  rates  that  correspond  to  a  weighted-average  cost  of  capital  consistent  with  a  market-
participant view. The discount rates are consistent with those used for investment decisions and take 
into  account  the  operating  plans  and  strategies  of  our  operating  segments.  Certain  other  key 
assumptions  utilized,  including  changes  in  membership,  premium,  health  care  costs,  operating 
expenses, fees, assessments and taxes and effective tax rates, are based on estimates consistent 
with those  utilized in our  annual budgeting  and  planning  process that  we believe are reasonable. 
However, if we do not achieve the results reflected in the assumptions and estimates, our goodwill 
impairment evaluations could be adversely affected, and we may impair a portion of our goodwill, 
which would adversely affect our operating results in the period of impairment. Impairments, if any, 
would be classified as an operating expense. 

Claim Liabilities 
Managed care claim liabilities mostly represent the Company’s estimate of medical costs incurred 
but not yet paid to providers based on experience and accumulated statistical data.  Loss-adjustment 
expenses  related  to  such  claims  are  currently  accrued  based  on  estimated  future  expenses 
necessary to process such claims.  Claim liabilities are the most significant estimate included in our 
consolidated financial statements.  Such estimate is developed consistently using standard actuarial 
methodologies based upon key assumptions, which vary by business segment.  The most significant 
assumptions  used  in  the  development  of  managed  care  claim  liabilities  include  current  payment 
experience,  trend  factors,  and  completion  factors.    Managed  care  trend  factors  in  our  standard 
actuarial  methodologies  include  contractual  requirements,  historic  utilization  trends,  the  interval 
between the date services are rendered and the date claims are paid, denied claims activity, disputed 

49 

 
Triple-S Management Corporation and Subsidiaries  
Notes to Consolidated Financial Statements 
December 31, 2018, 2017, and 2016 
(dollar amounts in thousands) 

claims activity, benefit changes, expected health care cost inflation, seasonality patterns, maturity of 
lines of business, changes in membership and other factors. 

Managed care claim liabilities also include a provision for adverse deviation, which is an estimate for 
known environmental factors that are reasonably likely to affect the required level of reserves. This 
provision for adverse deviation is intended to capture the potential adverse development from known 
environmental factors such as our entry into new geographical markets, changes in our geographic 
or product mix, the introduction of new customer populations, variation in benefit utilization, disease 
outbreaks, changes in provider reimbursement, fluctuations in medical cost trend, variation in claim 
submission  patterns  and  variation  in  claims  processing  speed  and  payment  patterns,  changes  in 
technology  that  provide  faster  access  to  claims  data  or  change  the  speed  of  adjudication  and 
settlement of claims, variability in claim inventory  levels, non-standard claim development, and/or 
exceptional situations that require judgmental adjustments in setting the reserves for claims. 

The Company contracts with various independent practice associations (IPAs) for certain medical 
care services provided to certain policies subscribers.  The IPAs are compensated on a capitation 
basis and capitation payables are included within claim liabilities. Capitation is amounts paid to the 
aforementioned IPAs on a fixed-fee per member per month basis.   

Claim liabilities also include unpaid claims and loss-adjustment expenses of the life and accident and 
health segment based  on  a case-basis estimate for reported claims, and on  estimates, based on 
experience, for unreported claims and loss-adjustment expenses.  The liability for policy and contract 
claims and claims expenses has been established to cover the estimated net cost of insured claims. 

Also included within the claim liabilities is the liability for losses and loss-adjustment expenses for 
the property and casualty segment which represents individual case estimates for reported claims 
and estimates for unreported losses, net of any salvage and subrogation based on past experience 
modified for current trends and estimates of expenses for investigating and settling claims. 

Claim  liabilities  are  necessarily  based  on  estimates  and,  while  management  believes  that  the 
amounts are adequate, the ultimate liability may be in excess of or less than the amounts provided.  
The  methods  for  making  such  estimates  and  for  establishing  the  resulting  liability  are  continually 
reviewed, and any adjustments are reflected in the consolidated statements of earnings in the period 
determined. 

Future Policy Benefits 
The liability for future policy benefits has been computed using the level-premium method based on 
estimated future investment yield, mortality, morbidity and withdrawal experience.  Mortality has been 
calculated principally on select and ultimate tables in common usage in the industry.  Withdrawals 
have  been  estimated  principally  based  on  industry  tables,  modified  by  Company’s  experience.  
Assumptions are established at the time the policy is issued and are generally not changed during 
the life of the policy.  The Company periodically reviews the adequacy of reserves for these policies 
on  an  aggregate  basis  using  actual  experience.  If  actual  experience  is  significantly  adverse 
compared to the original assumptions and a premium deficiency is determined to exist, any remaining 
unamortized DAC balance would be expensed to the extent not recoverable and the establishment 
of  a  premium  deficiency  reserve  may  be  required.  The  interest  rate  assumption  ranges  between 
3.90% and 5.75% for all years in issue.   

50 

 
Triple-S Management Corporation and Subsidiaries  
Notes to Consolidated Financial Statements 
December 31, 2018, 2017, and 2016 
(dollar amounts in thousands) 

Policyholder Deposits 
Amounts received for annuity contracts are considered deposits and recorded as a liability along with 
the accrued interest and reduced for charges and withdrawals.  Interest incurred on such deposits, 
which amounted to $2,615, $2,798, and $3,182, during the years ended December 31, 2018, 2017, 
and  2016, respectively, is  included  within the interest  expense  in the accompanying consolidated 
statements of earnings.  

Policyholder account balances for universal life and interest sensitive products are equal to policy 
account values. The policy account primarily comprises cumulative deposits received and interest 
credited  to  the  policyholder  less  cumulative  contract  benefits,  surrenders,  withdrawals,  maturities 
and contract charges for mortality or administrative expenses.  Interest rates credited to policyholder 
account balances during 2018  and 2017 ranged from 2.0%  to 4.5% for universal life and interest 
sensitive  products.    The  universal  life  and  interest  sensitive  products  represented  $83,563  and 
$75,956 of the policyholder deposits balance on the consolidated balance sheets as of December 
31, 2018 and 2017, respectively. 

Reinsurance 
In the normal course of business, the insurance-related subsidiaries seek to limit their exposure that 
may  arise  from  catastrophes  or  other  events  that  cause  unfavorable  underwriting  results  by 
reinsuring  certain  levels  of  risk  in  various  areas  of  exposure  with  other  insurance  enterprises  or 
reinsurers. 

Prospective  reinsurance  premiums,  commissions,  and  expense  reimbursements,  related  to 
reinsured  business  are  accounted  for  on  bases  consistent  with  those  used  in  accounting  for  the 
original  policies  issued  and  the  terms  of  the  reinsurance  contracts.    Accordingly,  reinsurance 
premiums are reported as prepaid reinsurance premiums and amortized over the remaining contract 
period in proportion to the amount of insurance protection provided. 

Premiums  ceded  and  recoveries  of  losses  and  loss-adjustment  expenses  under  prospective 
reinsurance treaties have been reported as a reduction of premiums earned and losses and loss-
adjustment  expenses  incurred,  respectively.    Property  and  casualty  commission  and  expense 
allowances received in connection with reinsurance ceded have been accounted for as a reduction 
of  the  related  policy  acquisition  costs  and  are  deferred  and  amortized  accordingly.    Amounts 
recoverable from reinsurers are estimated in a manner consistent with the claim liability associated 
with  the  reinsured  policy  and  are  presented  within  premium  and  other  receivables,  net  in  the 
accompanying  consolidated  balance  sheets.    Accounts  payable  and  accrued  liabilities  within  the 
accompanying consolidated balance sheets include $2,712 and $110,850 of advances received for 
hurricane related claims as of December 31, 2018 and 2017, respectively.   

Retroactive  reinsurance  reimburses  a  ceding  company  for  liabilities  incurred  as  a  result  of  past 
insurable  events  covered  under  contracts  subject  to  the  reinsurance.    In  certain  instances, 
reinsurance contracts cover losses both on a prospective basis and on a retroactive basis and where 
practical the Company bifurcates the prospective and retrospective elements of these reinsurance 
contracts  and  accounts  for  each  element  separately.    Initial  gains  in  connection  with  retroactive 
reinsurance contracts are deferred and amortized into income over the settlement period while losses 
are recognized immediately.  When changes in the estimated amount recoverable from the reinsurer 
or  in  the  timing  of  receipts  related  to  that  amount  occur,  a  cumulative  amortization  adjustment  is 
recognized in earnings in the period of the change so that the deferred gain reflects the balance that 
would  have  existed  had  the  revised  estimate  been  available  at  the  inception  of  the  reinsurance 
transaction.    The  Company  uses  the  recovery  method  to  amortize  any  deferred  gain,  which  is 

51 

 
Triple-S Management Corporation and Subsidiaries  
Notes to Consolidated Financial Statements 
December 31, 2018, 2017, and 2016 
(dollar amounts in thousands) 

included within the claims incurred in the accompanying consolidated statements of earnings.  The 
recovery method provides an amortization in proportion to the estimated recoveries made as of each 
reporting date as a percentage of total estimated recoveries.  

Income Taxes 
Income  taxes  are  accounted  for  under  the  asset  and  liability  method.    Deferred  tax  assets  and 
liabilities  are  recognized  for  the  future  tax  consequences  attributable  to  differences  between  the 
financial statement carrying amounts of existing assets and liabilities and their respective tax bases 
and operating loss and tax credit carryforwards.  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.  The Company recognizes the  effect of income tax positions  only  if 
those positions are more likely than not of being sustained.  Recognized income tax positions are 
measured  at  the  largest  amount  that  is  greater  than  50%  likely  of  being  realized.    Changes  in 
recognition or measurement are reflected in the period in which the change in circumstances occurs. 

The  Company  records  any  interest  and  penalties  related  to  unrecognized  tax  benefits  within  the 
operating expenses in the consolidated statement of earnings. 

Health Insurance Providers Fee 
The  Patient  Protection  and  Affordable  Care  Act  as  amended  by  the  Health  Care  and  Education 
Reconciliation Act mandates an annual Health Insurance Providers Fee (HIP Fee).  The annual HIP 
Fee becomes payable to the U.S. Treasury once the entity provides health insurance for any U.S. 
health risk each applicable calendar year.  The initial estimated annual fee is accrued as of January 
1, with a corresponding deferred cost that is amortized over 12 months on a straight-line basis. The 
fee payment is due on September 30 of each year.  The Company incurred approximately $50,100 
and  $44,100  of  such  fees  in  2018  and  2016,  respectively,  which  are  presented  within  operating 
expenses in the accompanying consolidated statements of earnings. The HIP Fee was waived for 
all health insurance providers during the year ended December 31, 2017. 

Insurance-Related Assessments 
The  Company  records  a  liability  for  insurance-related  assessments  when  the  following  three 
conditions are met: (1) the assessment has been imposed or the information available prior to the 
issuance of the consolidated financial statements indicates it is probable that an assessment will be 
imposed;  (2) the  event  obligating  an  entity  to  pay  (underlying  cause  of)  an  imposed  or  probable 
assessment has occurred on or before the date of the consolidated financial statements; and (3) the 
amount of the assessment can be reasonably estimated.  A related asset is recognized when the 
paid or accrued assessment is recoverable through either premium taxes or policy surcharges. 

Commitments and Contingencies 
Liabilities for loss contingencies arising from claims, assessments, litigation, fines, and penalties and 
other sources are recorded when it is probable that a liability has been incurred and the amount of 
the assessment and/or remediation can be reasonably estimated.  Legal costs incurred in connection 
with loss contingencies are expensed as incurred.  Recoveries of costs from third parties, which are 
probable  of  realization,  are  separately  recorded  as  assets,  and  are  not  offset  against  the  related 
liability. 

52 

 
 
 
 
Triple-S Management Corporation and Subsidiaries  
Notes to Consolidated Financial Statements 
December 31, 2018, 2017, and 2016 
(dollar amounts in thousands) 

Share-Based Compensation 
Share-based compensation is measured at the fair value of the award and recognized as an expense 
in the consolidated financial statements over the vesting period.   

Earnings per Share 
Basic earnings per share excludes dilution and is computed by dividing net income available to all 
classes of common stockholders by the weighted average number of all classes of common shares 
outstanding  for  the  period,  excluding  non-vested  restricted  stocks.    Diluted  earnings  per  share  is 
computed  in  the  same  manner  as  basic  earnings  per  share  except  that  the  number  of  shares  is 
increased to include the number of additional common shares that would have been outstanding if 
the potentially dilutive common shares had been issued.  Dilutive common shares are included in 
the diluted earnings per share calculation using the treasury stock method. 

Recently Adopted Accounting Standards 
On  January  5,  2016,  the  FASB  issued  guidance  to  enhance  the  reporting  model  for  financial 
instruments  to  provide  users  of  financial  statements  with  more  decision-useful  information 
(Accounting  Standard  Update  (ASU)  2016-01).    Among  the  many  targeted  improvements  to  U.S. 
GAAP are (1) requiring equity investments, except those accounted for under the equity method of 
accounting  or those that result in consolidation of the  investee, to be measured  at fair  value  with 
changes in fair value recognized in net income; (2) simplifying the impairment assessment of equity 
investments without readily determinable fair values by requiring a qualitative assessment to identify 
impairment;  (3)  eliminating  the  requirement  to  disclose  the  fair  value  of  financial  instruments 
measured at amortized cost for entities that are not public business entities; and (4) clarifying that 
an  entity  should  evaluate  the  need  for  a  valuation  allowance  on  a  deferred  tax  asset  related  to 
available-for-sale securities in combination with the entity’s other deferred tax assets.  This guidance 
applies to all entities that hold financial assets or owe financial liabilities. The Company also adopted 
guidance issued  by  FASB  on  March  9,  2018 that removes the previous  guidance for Other Than 
Temporary  Impairment  of  Certain  Investments  in  Equity  Securities  as  required  by  SEC  Staff 
Accounting Bulletin (SAB) No. 117 and SEC Release No. 33-9273, since it is no longer applicable.   
For  public  companies,  these  amendments  became  effective  for  fiscal  years  beginning  after 
December 15, 2017, including interim periods within those fiscal years.  The Company adopted this 
guidance for equity securities effective January 1, 2018.  A cumulative-effect adjustment of $39,882 
was made from accumulated other comprehensive income to the beginning retained earnings at the 
implementation date.   

On  February  28,  2018,  the  Financial  Accounting  Standard  Board  (FASB)  issued  guidance  for 
Technical  Corrections  and  Improvement  to  Financial  Instruments  –  Overall:  Recognition  and 
Measurement  of  Financial  Assets  and  Financial  Liabilities.    Areas  for  correction  or  improvement 
include  (1)  equity  securities  without  a  readily  determinable  fair  value—discontinuation,  (2)  equity 
securities  without  a  readily  determinable  fair  value—adjustments,  (3)  forward  contracts  and 
purchased options, (4) presentation requirements for certain fair value option liabilities, (5) fair value 
option liabilities denominated in a foreign currency, and (6) transition guidance for equity securities 
without  a  readily  determinable  fair  value.  For  public  companies,  these  amendments,  became 
effective on a prospective basis, for fiscal years beginning after December 15, 2017, including interim 
periods within those fiscal years.  For public entities with fiscal years beginning between December 
15, 2017 and June 15, 2018 adoption of these amendments was not effective until the interim period 
beginning after June 15, 2018.  The Company adopted this guidance effective June 30, 2018.  The 
adoption  of  this  guidance  did  not  have  a  material  impact  on  the  presentation  of  the  Company’s 
consolidated results of operations.   

53 

 
Triple-S Management Corporation and Subsidiaries  
Notes to Consolidated Financial Statements 
December 31, 2018, 2017, and 2016 
(dollar amounts in thousands) 

Future Adoptions of Accounting Standards 
On  February  25,  2016,  the  Financial  Accounting  Standards  Board  (FASB)  issued  guidance  to 
increase transparency and comparability among organizations by requiring the recognition of a lease 
right-of-use  (ROU)  asset  and  a  lease  liability,  initially  measured  at  the  present  value  of  the  lease 
payment on the balance sheet, for both finance and operating leases with lease terms of more than 
12  months.    The  classification  of  finance  or  operating  will  determine  whether  lease  expense  is 
recognized  based  on  an  effective  interest  method  or  on  a  straight-line  basis  over  the  term  of  the 
lease, respectively.  Lessors are required to account for leases using an approach that is substantially 
equivalent to existing guidance for sales-type leases, direct financing leases and operating leases.  
In  July  2018,  the  FASB  issued  the  following  guidance  “Leases  –  Targeted  Improvements”  and 
“Codification Improvement to Leases” to assist in the implementation of leases and address certain 
technical corrections and improvement to the recently issued lease standard.  Amendments include 
an additional transition method that allows entities to apply the new standard on the adoption date 
and recognize a cumulative effect adjustment to the opening balance of retained earnings, as well as 
a  new  practical  expedient  for  lessors  and  other  implementation  considerations.    For  public 
companies, the amended guidance is effective for fiscal years beginning after December 15, 2018, 
including interim periods within those fiscal years.  The Company will adopt the standard effective 
January 1, 2019 using a modified prospective approach by recording a cumulative effect adjustment 
to beginning retained earnings at the implementation  date for leases existing as of that date. The 
Company does not expect the standard to have a material impact in its consolidated balance sheet 
following the recognition of ROU assets and lease liabilities for its operating leases.  We do not expect 
the adoption of this guidance to have a material impact on our consolidated statement of earnings or 
cash flows.  In addition, the Company implemented control processes and procedures, as necessary, 
based on changes resulting from the new standard. 

On  June  16,  2016,  the  FASB  issued  guidance  to  provide  financial  statement  users  with  more 
decision-useful  information  about  the  expected  credit  losses  on  financial  instruments  and  other 
commitments  to  extend  credit  held  by  a  reporting  entity  at  each  reporting  date  by  replacing  the 
incurred  loss  impairment  methodology  in  current  U.S.  GAAP  with  a  methodology  that  reflects 
expected credit losses and requires consideration of a broader range of reasonable and supportable 
information to inform credit loss estimates.  For public companies, these amendments are effective 
for fiscal years beginning after December 15, 2019, including interim periods within those fiscal years.  
The Company does not expect a material impact from the implementation of this guidance. 

On January 26, 2017, the FASB issued guidance to simplify the manner in which an entity is required 
to evaluate goodwill for impairment by eliminating Step 2 from the goodwill impairment test.  Step 2 
measures a goodwill impairment loss by comparing the implied fair value of a reporting unit’s goodwill 
with the carrying amount of that goodwill.  Instead, under the amendments in this guidance, an entity 
should (1) perform its annual  or interim goodwill impairment test by comparing  the fair value of a 
reporting unit with its carrying amount, and (2) recognize an impairment charge for the amount by 
which the carrying amount exceeds the reporting unit’s fair value, with the understanding that the 
loss  recognized  should  not  exceed  the  total  amount  of  goodwill  allocated  to  that  reporting  unit.  
Additionally, this guidance removes the requirements for any reporting unit with a zero or negative 
carrying amount to perform a qualitative assessment and, if it fails such qualitative test, to perform 
Step 2 of the goodwill impairment test.  For public companies, these amendments, which should be 
applied  on  a  prospective  basis,  are  effective  for  fiscal  years  beginning  after  December  15,  2019, 
including interim periods within those fiscal years.   

On July 16, 2018, the FASB issued guidance Codification Improvements which represents changes 
to clarify, correct errors in, or make minor improvements to the Codification.  The change addresses 
conflicts or unclear intent in the following areas: (1) Comprehensive Income – Overall, (2) Debt – 
Modifications  and  Extinguishments,  (3)  Distinguishing  Liabilities  from  Equity  –  Overall,  (3) 
Compensation  –  Stock  Compensation  –  Income  Taxes,  (4)  Derivatives  and  Hedging  –  Overall  – 

54 

 
Triple-S Management Corporation and Subsidiaries  
Notes to Consolidated Financial Statements 
December 31, 2018, 2017, and 2016 
(dollar amounts in thousands) 

Other  Presentation  Matters,  (5)  Fair  Value  Measurement  –  Overall  and  (6)  Financial  Services  – 
Brokers and Dealers – Liabilities and Financial Services – Depository and Lending.  Some of the 
amendments  in  this  update  do  not  require  transition  guidance  and  are  effective  immediately.  
However, many of the amendments do have transition guidance, effective for public companies for 
annual  periods  beginning  after  December  15,  2018.    The  guidance  will  be  implemented  effective 
January 1, 2019.  The Company does not expect a material impact from the implementation of this 
guidance. 

On  August  15,  2018,  the  FASB  issued  guidance  for  Financial  Services  –  Insurance:  Targeted 
Improvements  to  the  Accounting  for  Long-Duration  Contracts  which  provides  meaningful 
improvements to the existing recognition, measurement, presentation, and disclosure requirements 
for long-duration contracts issued by an insurance entity.  The amendments improve the timeliness 
of recognizing changes in the liability for future policy benefits for long-duration contracts by requiring 
that  underlying  cash  flow  assumptions  are  reviewed  and  updated  at  least  annually  to  current 
estimates without a provision for adverse deviation.  The resulting change to the liability for future 
policy benefits related to the assumption changes will be recognized within earnings.  The discount 
rate  used  to  discount  future  cash  flows  will  be  updated  both  annually  and  at  each  interim  period 
based on the yield of an upper-medium grade fixed-income instrument.  The resulting change in the 
liability  for  Future  Policy  Benefits  will  be  reported  through  Other  Comprehensive  Income.    The 
guidance also introduces a new concept for market risk benefits for certain contracts which protect 
the  contract  holder  from  other-than-normal  capital  market  risk  and  which  expose  the  insurance 
company  to  such  risks.    These  contracts  will  be  required  to  be  measured  at  fair  value  with  the 
corresponding  changes  in  value  reported  through  net  income.    Additionally,  the  amendment 
simplifies the amortization of deferred acquisition costs and other balances amortized in proportion 
to premiums, gross profits, or gross margins, and requires that those balances be amortized on a 
constant level basis over the expected term of the related contracts.  This guidance also requires 
increased and enhanced disclosure requirements for long-duration contracts and related balances.  
For public companies, these amendments will be applied for fiscal years beginning after December 
15, 2020.  The Company is currently evaluating the impact the adoption of this guidance may have 
in its consolidated financial statements. 

On  August  27,  2018,  the  FASB  issued  guidance  for  Fair  Value  Measurement  –  Disclosure 
Framework  –  Changes  to  the  Disclosure  Requirement  for  Fair  Value  Measurement.    This  update 
focuses  on  improving  the  effectiveness  of  disclosures  in  the  notes  to  the  financial  statements  by 
facilitating clear communication of the information required by U.S. GAAP that is most important to 
users of each entity’s financial statements.  Specifically certain disclosure requirements are removed 
(the amount of, and reasons for, transfer between Level 1 and Level 2 of the fair value hierarchy; the 
policy  for  timing  of  transfers  between  levels;  the  valuation  processes  for  Level  3  fair  value 
measurements) while it modifies and adds certain other disclosures (the changes in unrealized gains 
and losses for the period included in other comprehensive income for recurring Level 3 fair value 
measurements  held  at  the  end  of  the  reporting  period,  and  the  range  and  weighted  average  of 
significant unobservable inputs used to develop Level 3 fair value measurements).  The amendments 
regarding changes in unrealized gains and  losses, the range and  weighted  average of significant 
unobservable inputs used to develop Level 3 fair value measurements, and the narrative description 
of measurement uncertainty should be applied prospectively for only the most recent period in the 
initial fiscal year of adoption.  All other amendments should be applied retrospectively to all periods 
presented upon their effective date.  For public companies, these amendments will be applied for 
fiscal years beginning after December 15, 2019.  The adoption of this guidance should not have a 
material impact on the presentation of the Company’s consolidated result of operations. 

55 

 
Triple-S Management Corporation and Subsidiaries  
Notes to Consolidated Financial Statements 
December 31, 2018, 2017, and 2016 
(dollar amounts in thousands) 

On August 28, 2018, the FASB issued guidance for Compensation – Retirement Benefits – Defined 
Benefit Plans – General which addresses changes to the disclosure requirement for defined benefit 
plans.  The  amendments  in  this  guidance  modify  the  disclosure  requirements  for  employers  that 
sponsor  defined  benefit  pension  or  other  postretirement  plans.    Specifically  certain  disclosure 
requirements are removed (i.e. the amounts of accumulated other comprehensive income expected 
to be recognized as components of net periodic benefit cost over the next fiscal year, related party 
disclosures concerning the amount of future annual benefits covered by an insurance and annuity 
contracts and significant transactions between the employer and related parties and the plan) while 
certain  other  disclosures  are  added  (i.e.  the  weighted-average  interest  crediting  rates  for  cash 
balance plans and other plans with promised interest crediting rates, an explanation for the reasons 
for significant gains and losses related to changes in the benefit obligation for the period).   For public 
companies, these amendments, will be applied for fiscal years beginning after December 15, 2020.  
The  adoption  of  this  guidance  should  not  have  a  material  impact  on  the  presentation  of  the 
Company’s consolidated result of operations.  

On August 29, 2018, the FASB issued guidance for Intangibles – Goodwill and Other – Internal-Use 
Software.    Guidance  addresses  customer’s  accounting  for  implemented  costs  incurred  in  a  cloud 
computing arrangement that is a service contract and aims to reduce complexity in the accounting 
for  costs  of  implementing  a  cloud  computing  service  arrangement.    The  amendments  require  a 
customer  in  a  hosting  arrangement  that  is  a  service  contract  to  determine  which  implementation 
costs to capitalize as an asset related to service contract and which costs to expense.  Additionally, 
it requires the customer to expense the capitalized implementation costs over the term of the hosting 
arrangement.  For public companies, these amendments, will be applied on a prospective basis, for 
fiscal years beginning after December 15, 2019, including interim periods within those fiscal years.  
The  adoption  of  this  guidance  should  not  have  a  material  impact  on  the  presentation  of  the 
Company’s consolidated result of operations.  

Other than the accounting pronouncements disclosed above, there were no other new accounting 
pronouncements  issued  during  the  year  that  could  have  a  material  impact  on  the  Corporation’s 
financial position, operating results or financials statement disclosures. 

56 

 
 
 
Triple-S Management Corporation and Subsidiaries  
Notes to Consolidated Financial Statements 
December 31, 2018, 2017, and 2016 
(dollar amounts in thousands) 

3. 

Investment in Securities 

The amortized cost for debt securities and cost for alternative investments, gross unrealized gains, 
gross  unrealized  losses,  and  estimated  fair  value  for  the  Company’s  investments  in  securities  by 
major security type and class of security as of December 31, were as follows: 

Fixed maturities available for sale
Obligations of government-
sponsored enterprises
U.S. Treasury securities and 

obligations of U.S.
government instrumentalities

Obligations of the 

Commonwealth of Puerto Rico
and its instrumentalities

Municipal securities
Corporate bonds
Residential mortgage-backed securities
Collateralized mortgage obligations

2018

Amortized
Cost

Gross
Unrealized
Gains

Gross
Unrealized
Losses

Estimated
Fair
Value

$       

21,470

$          

120

$                

(1)

$       

21,589

174,675

2,349

-

177,024

8,295
692,205
186,085
75,373
10,266

-
18,112
9,724
1,298
208

-
(538)
(239)
-
-

8,295
709,779
195,570
76,671
10,474

Total fixed maturities available for sale

$  

1,168,369

$     

31,811

$           

(778)

$ 

1,199,402

57 

 
 
Triple-S Management Corporation and Subsidiaries  
Notes to Consolidated Financial Statements 
December 31, 2018, 2017, and 2016 
(dollar amounts in thousands) 

Securities available for sale
Fixed maturities

Obligations of government-
sponsored enterprises
U.S. Treasury securities and 

obligations of U.S.
government instrumentalities

Obligations of the 

Commonwealth of Puerto Rico
and its instrumentalities

Municipal securities
Corporate bonds
Residential mortgage-backed securities
Collateralized mortgage obligations

2017

Amortized
Cost

Gross
Unrealized
Gains

Gross
Unrealized
Losses

Estimated
Fair
Value

$         

1,431

$            

13

$                 
-

$        

1,444

118,858

41

(550)

118,349

8,059
771,789
217,046
32,465
22,003

34
30,468
17,767
2
10

48,335

50,072
559
50,631

-
(1,467)
(489)
(355)
(337)

8,093
800,790
234,324
32,112
21,676

(3,198)

1,216,788

(223)
(244)
(467)

342,308
34,985
377,293

Total fixed maturities

1,171,651

Equity securities

Mutual Funds
Alternative investments

Total equity securities

292,459
34,670
327,129

Total

$   

1,498,780

$      

98,966

$         

(3,665)

$  

1,594,081

2018

Amortized
Cost

Gross
Unrealized
Gains

Gross
Unrealized
Losses

Estimated
Fair
Value

Fixed maturities held to maturity
U.S. Treasury securities and

obligations of U.S.
government instrumentalties

Residential mortgage-backed securities
Certificates of deposits

Total

$            

$          

$           

617
190
1,685
2,492

125
2
-
127

-
$                 
-
-
$                 
-

742
192
1,685
2,619

$         

$          

$        

58 

 
 
 
      
       
             
      
            
               
                  
            
          
               
                  
         
Triple-S Management Corporation and Subsidiaries  
Notes to Consolidated Financial Statements 
December 31, 2018, 2017, and 2016 
(dollar amounts in thousands) 

2017

Gross

Gross

Estimated

Amortized

Unrealized

Unrealized

Cost

Gains

Losses

Fair

Value

Securities held to maturity

U.S. Treasury securities and

obligations of U.S.

government instrumentalties

$            

617

$          

154

$                 
-

$           

771

Residential mortgage-backed securities

Certificates of deposits

191

1,511

2

-

-

-

193

1,511

$         

2,319

$          

156

$                 
-

$        

2,475

Other invested assets - Alternative investments

$      

72,627

$       

2,042

cost

gains

losses
$           

(654)

fair value
$      
74,015

Amortized

unrealized

unrealized

Estimated

2018

Gross

Gross

59 

 
 
 
 
 
            
               
                  
          
               
                  
Triple-S Management Corporation and Subsidiaries  
Notes to Consolidated Financial Statements 
December 31, 2018, 2017, and 2016 
(dollar amounts in thousands) 

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 December 31, were as follows: 

Less than 12 months

12 m onths or longer

Gross

Gross

Total

Gross

Estimated Unrealized Num ber of Estimated Unrealized Num ber of Estim ated Unrealized Num ber of

Fair Value

Loss

Securities Fair Value

Loss

Securities Fair Value

Loss

Securities

2018

Fixed maturities available for sale

Obligations of government-

sponsored enterprises

Municipal securities

Corporate bonds

$     

1,469

$          

(1)

62,328

52,539

(349)

(239)

Total fixed maturities

$ 

116,336

$      

(589)

1

10

18

29

$              
-

$            
-

17,648

(189)

-

-

$     

17,648

$      

(189)

Other invested assets - Alternative investments

$     

7,399

$      

(351)

3

$     

10,447

$      

(303)

-

3

-

3

2

$      

1,469

$           

(1)

79,976

52,539

(538)

(239)

$  

133,984

$       

(778)

$    

17,846

$       

(654)

1

13

18

32

5

2017

Less than 12 m onths

12 months or longer

Gross

Gross

Total

Gross

Estim ated Unrealized Num ber of Estimated Unrealized Num ber of Estim ated Unrealized Num ber of

Fair Value

Loss

Securities Fair Value

Loss

Securities Fair Value

Loss

Securities

Securites available for sale

Fixed maturities

U.S. Treasury securities and 

obligations of U.S. 

governmental instrumentalities

$   

96,617

$      

(550)

Municipal securities

Corporate bonds

Residential mortgage-backed

securities

Collateralized mortgage obligations
Total fixed maturities

Equity securities

Mutual funds

Alternative investments

162,731

80,374

(1,467)

(489)

31,736

13,630
385,088

$ 

(355)

(239)
(3,100)

$   

42,983

9,986

(223)

(212)

Total equity securities
Total for securities available for sale

52,969
438,057

$ 

(435)
(3,535)

$   

7

27

16

19

3
72

6

5

11
83

$              
-

$            
-

-

-

-

-

-

-

7,294
7,294

$       

(98)
(98)

$        

-

3,162

-

(32)

3,162
10,456

$     

(32)
(130)

$      

-

-

-

-

2
2

-

1

1
3

96,617

162,731

80,374

(550)

(1,467)

(489)

31,736

(355)

20,924
392,382

$  

(337)
(3,198)

$    

42,983

13,148

(223)

(244)

56,131
448,513

$  

(467)
(3,665)

$    

7

27

16

19

5
74

6

6

12
86

The  Company  regularly  monitors  and  evaluates  the  difference  between  the  amortized  cost  and 
estimated fair value of fixed maturity securities.  For fixed maturity securities with a fair value below 
amortized 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, (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 Company’s intent to sell or the likelihood of a required sale prior to 
recovery, (4) the recoverability of principal and interest, and (5) other factors, as applicable.  This 
process is not exact and requires further consideration of risks such as credit and interest rate risks.  
Consequently,  if  an  investment’s  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 Company’s analysis, along with the judgment that must be applied 
in the analysis, it is possible that the Company 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 investee’s ability to meet future contractual obligations may be different than what 

60 

 
 
 
 
 
Triple-S Management Corporation and Subsidiaries  
Notes to Consolidated Financial Statements 
December 31, 2018, 2017, and 2016 
(dollar amounts in thousands) 

the Company determined during its analysis, which may lead to a different impairment conclusion in 
future periods.   

If after monitoring and analyzing impaired securities, the Company determines that a decline in the 
estimated fair value of any available-for-sale or held-to-maturity security below cost is other-than-
temporary, the carrying amount of the security is reduced to its fair value in accordance with current 
accounting guidance.  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.  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 Company’s process for identifying and reviewing available for sale and other 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 $100. 

•  For  any  securities  with  a  gross  unrealized  investment  loss  we  might  review  and  evaluate 
investee’s  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.   

•  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. 

•  Determination  of  the  status  of  each  analyzed  security  as  other-than-temporary  or  not,  with 

documentation of the rationale for the decision; and 

The  Company  reviews  the  available  for  sale  and  other  invested  assets  portfolios  under  the 
Company’s  impairment  review  policy.    Given  market  conditions  and  the  significant  judgments 
involved,  there  is  a  continuing  risk  that  declines  in  fair  value  may  occur  and  material  other-than-
temporary impairments may be recorded in future periods.  The Company from time to time may sell 
investments as part of its asset/liability management process or to reposition its investment portfolio 
based on current and expected market conditions. 

Obligations of Government-Sponsored Enterprises and Municipal Securities:  The unrealized losses 
of  these  securities  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, 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 Company does not intend to sell the investments and it is not 
more likely than not that the Company will be required to sell the investments before recovery of their 
amortized  cost  basis,  which  may  be  maturity;  and  because  the  Company  expects  to  collect  all 
contractual cash flows, these investments are not considered other-than-temporarily impaired. 

Corporate Bonds:  The unrealized losses of these bonds were principally caused by fluctuations in 
interest  rates  and  general  market  conditions.    All  corporate  bonds  with  an  unrealized  loss  have 
investment grade ratings.  Because the decline in estimated fair value is principally attributable to 
changes in interest rates; because the Company does not intend to sell the investments and it is not 

61 

 
Triple-S Management Corporation and Subsidiaries  
Notes to Consolidated Financial Statements 
December 31, 2018, 2017, and 2016 
(dollar amounts in thousands) 

more likely than not that the Company will be required to sell the investments before recovery of their 
amortized  cost  basis,  which  may  be  maturity;  and  because  the  Company  expects  to  collect  all 
contractual cash flows, these investments are not considered other-than-temporarily impaired. 

Alternative Investments:  As of December 31, 2018, alternative investments with unrealized losses 
are not considered other-than-temporarily  impaired  based on market conditions and the length  of 
time the funds have been in a loss position.   

Maturities of investment securities classified as available for sale and held to maturity at December 
31, 2018 were as follows: 

Securities available for sale
Due in one year or less
Due after one year through five years
Due after five years through ten years
Due after ten years
Residential mortgage-backed securities
Collateralized mortgage obligations

Securities held to maturity
Due in one year or less
Due after ten years
Residential mortgage-backed securities

Amortized
Cost

Estimated
Fair Value

$       

18,707
355,334
428,212
280,477
75,373
10,266

$       

18,809
357,777
435,669
300,002
76,671
10,474

$   

1,168,369

$   

1,199,402

$         

1,685
617
190

$         

1,685
742
192

$         

2,492

$         

2,619

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.  

Investments  with  an  amortized  cost  of  $7,982  and  $5,229  (fair  value  of  $8,217  and  $5,571)  at 
December 31, 2018 and 2017, respectively, were deposited with the Commissioner of Insurance to 
comply with the deposit requirements of the Insurance Code of the Commonwealth of Puerto Rico 
(the Insurance Code).   

62 

 
 
 
 
Triple-S Management Corporation and Subsidiaries  
Notes to Consolidated Financial Statements 
December 31, 2018, 2017, and 2016 
(dollar amounts in thousands) 

4. 

Realized and Unrealized Gains 

Information regarding realized and unrealized gains and losses from investments for the years ended 
December 31, is as follows: 

2018

2017

2016

Realized gains (losses)
Fixed maturity securities:

Securities available for sale

Gross gains
Gross losses

$           

3,730
(18,627)

$           

1,460
(2,176)

$           

3,086
(2,744)

Total fixed maturity securities

(14,897)

(716)

342

Equity investments:
Gross gains
Gross losses
Gross losses from other-than-temporary

impairments

Total equity investments

Other invested assets:
Gross gains
Gross losses

Total other invested assets

16,045
(2,290)

-

13,755

1,492
(52)

1,440

12,154
(558)

(49)

11,547

-
-

-

19,674
(1,203)

(1,434)

17,037

-
-

-

Net realized gains on securities

$              

298

$         

10,831

$         

17,379

2018

2017

2016

Changes in unrealized gains (losses)
Recognized in accumulated other
comprehensive income (loss)

Fixed maturities – available for sale
Other invested assets
Equity securities 

Not recognized in the consolidated

financial statements

$       

(14,104)
1,073
-

$         

(2,203)
-
20,514

$          

1,953
-
2,172

Fixed maturities – held to maturity

$              

(29)

$              

(20)

$              

(19)

The change in deferred tax asset (liability) on unrealized gains (losses) recognized in accumulated 
other  comprehensive  income  during  the  years  2018,  2017,  and  2016  was  $2,292,  $(3,846),  and 
$(1,085), respectively. 

As  of  December 31,  2018  and  2017  no  individual  investment  in  securities  exceeded  10%  of 
stockholders’ equity. 

63 

 
 
 
 
 
Triple-S Management Corporation and Subsidiaries  
Notes to Consolidated Financial Statements 
December 31, 2018, 2017, and 2016 
(dollar amounts in thousands) 

5. 

Net Investment Income 

Interest and/or dividend income for the years ended December 31 were are as follows: 

Fixed maturities
Equity securities
Other invested assets
Policy loans
Cash equivalents and

interest-bearing deposits

Other

2018

2017

2016

$       

43,873
12,261
1,679
754

$       

38,414
10,728
-
709

$       

37,139
9,666
-
619

1,407
1,935

798
966

257
1,232

Total

$       

61,909

$       

51,615

$       

48,913

6. 

Premium and Other Receivables, Net 

Premium and other receivables, net as of December 31 were as follows: 

Premium
Self-funded group receivables
FEHBP
Agent balances
Accrued interest
Reinsurance recoverable
Other

Less allowance for doubtful receivables:

Premium
Other

2018

2017

$      

94,613
31,184
14,030
30,224
12,426
399,202
88,807

$      

103,027
39,859
13,346
32,818
14,331
661,679
70,150

670,486

935,210

32,487
9,555

42,042

26,490
9,393

35,883

Premium and other receivables, net

$      

628,444

$      

899,327

As of December 31, 2018 and 2017, the Company had premiums and other receivables of $54,329 
and $81,838, respectively, from the Government of Puerto Rico, including its agencies, municipalities 
and public corporations. The related allowance for doubtful receivables as of December 31, 2018 
and 2017 were $20,984 and $16,436, respectively. 

Reinsurance  recoverable  as  of  December  31,  2018  and  2017  includes  $350,353  and  $613,000 
related to expected catastrophe losses covered by the Property and Casualty segment’s reinsurance 
program, reflecting the anticipated gross losses related to Hurricanes Irma and Maria, which made 
landfall in Puerto Rico during the month of September 2017. 

64 

 
 
 
        
        
        
        
      
        
Triple-S Management Corporation and Subsidiaries  
Notes to Consolidated Financial Statements 
December 31, 2018, 2017, and 2016 
(dollar amounts in thousands) 

7. 

Deferred Policy Acquisition Costs and Value of Business Acquired 

The movement of deferred policy acquisition costs (DPAC) and value of business acquired (VOBA) 
for the years ended December 31 is summarized as follows:  

DPAC

VOBA

Total

Balance, December 31, 2015

$     

161,731

$      

28,917

$     

190,648

Additions
VOBA interest at an average rate of 5.15%
Amortization

Net change

47,742
-
(40,848)

6,894

-
1,381
(4,136)

(2,755)

47,742
1,381
(44,984)

4,139

Balance, December 31, 2016

168,625

26,162

194,787

Additions
VOBA interest at an average rate of 5.17%
Amortization

Net change

48,701
-
(39,605)

9,096

-
1,253
(4,348)

(3,095)

48,701
1,253
(43,953)

6,001

Balance, December 31, 2017

177,721

23,067

200,788

Additions
VOBA interest at an average rate of 5.11%
Amortization

Net change

51,144
-
(35,005)

16,139

-
1,120
(2,888)

(1,768)

51,144
1,120
(37,893)

14,371

Balance, December 31, 2018

$     

193,860

$      

21,299

$     

215,159

A portion of the amortization of the DPAC and VOBA is recorded as an amortization expense and 
included within the operating expenses in the accompanying consolidated statements of earnings.  
The remaining portion of the DPAC and VOBA amortization includes the unrealized investment gains 
and losses that would have been amortized if such gains and losses had been realized, which for 
the years ended December 31, 2018 and 2017 amounted to $2,113 and $598, respectively, and is 
included within the unrealized gains on securities component of other comprehensive income. 

The estimated amount of the year-end VOBA balance expected to be amortized during the next five 
years is as follows: 

Year ending December 31:

2019
2020
2021
2022
2023

$          

2,939
2,064
1,845
1,630
1,697

65 

 
 
 
 
Triple-S Management Corporation and Subsidiaries  
Notes to Consolidated Financial Statements 
December 31, 2018, 2017, and 2016 
(dollar amounts in thousands) 

8. 

Property and Equipment, Net 

Property and equipment, net as of December 31 are composed of the following:  

Land
Buildings and leasehold improvements
Office furniture and equipment
Computer equipment and software
Automobiles

Less accumulated depreciation and amortization

2018

2017

$      

10,976
68,424
39,421
137,183
795

256,799

174,876

$      

10,976
64,856
35,070
116,244
701

227,847

153,131

Property and equipment, net

$      

81,923

$      

74,716

The Company recognized  depreciation expense on property and equipment of $12,583,  $11,930, 
and $12,335 for the years ended December 31, 2018, 2017, and 2016, respectively. 

9. 

Goodwill 

Certain business combination transactions have resulted in goodwill, which represents the excess of 
the  acquisition cost  over the fair  value of  net assets acquired, and is  assigned to reporting  units.  
Goodwill recorded as of December 31, 2018 and 2017 was $25,397 which is all attributable to the 
Medicare Advantage reporting unit within the Managed Care segment. 

As  required  by  accounting  guidance,  the  2018,  2017  and  2016  annual  goodwill  impairment  tests 
were performed, and based on the results of the tests, no impairment charge was required.  If the 
Company  does  not  achieve  its  earnings  objectives  or  the  cost  of  capital  raises  significantly,  the 
assumptions and estimates underlying these impairment tests could be adversely affected and result 
in future impairment charges that would negatively impact its operating results.  Cumulative goodwill 
impairment  charges  were  $2,369  as  of  December  31,  2018  and  2017.    All  cumulative  goodwill 
impairment is related to the health clinic reporting unit which has been fully impaired. 

66 

 
 
 
 
       
       
       
       
      
      
            
            
      
      
      
      
Triple-S Management Corporation and Subsidiaries  
Notes to Consolidated Financial Statements 
December 31, 2018, 2017, and 2016 
(dollar amounts in thousands) 

10.  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 Definition: 

Level 1 

Level 2 

Level 3 

Inputs  are  unadjusted,  quoted  prices  for  identical  assets  or  liabilities  in  active 
markets at the measurement date. 

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. 

Unobservable  inputs  that  reflect  management’s  best  estimate  of  what  market 
participants would use in pricing the asset or liability at the measurement date. 

The Corporation uses observable  inputs when available. Fair value  is based upon quoted market 
prices when available. The Corporation limits valuation adjustments to those deemed necessary to 
ensure that the security’s fair value adequately represents the price that would be received or paid 
in the marketplace. Valuation adjustments may include consideration of counterparty credit quality 
and liquidity as well as other criteria.  The estimated fair value amounts are subjective in nature and 
may  involve  uncertainties  and  matters  of  significant  judgment  for  certain  financial  instruments. 
Changes in the underlying assumptions used in estimating fair value could affect the results.  The 
fair value measurement levels are not indicative of risk of investment.  

Transfers into or out of the Level 3 category occur when unobservable inputs, such as the Company’s 
best  estimate  of  what  a  market  participant  would  use  to  determine  a  current  transaction  price, 
become more or less significant to the fair value measurement.  Transfers between levels, if any, are 
recorded as of the actual date of the event or change in circumstance that caused the transfer.  There 
were no transfers between Levels 1 and 2 during the years ended December 31, 2018 and 2017.  

67 

 
Triple-S Management Corporation and Subsidiaries  
Notes to Consolidated Financial Statements 
December 31, 2018, 2017, and 2016 
(dollar amounts in thousands) 

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 year ended December 31 is as follows: 

Fair Value Measurements Using Significant Unobservable Inputs (Level 3)

Balance as of January 1,

Realized gains
Unrealized in other accumulated
comprehensive income

Purchases
Sales
Capital Distributions

2018

$                             
-

-

-
3,805
-
-

Balance as of December 31,

$                    

3,805

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 3. 

68 

 
 
 
Triple-S Management Corporation and Subsidiaries  
Notes to Consolidated Financial Statements 
December 31, 2018, 2017, and 2016 
(dollar amounts in thousands) 

The  following  table  summarizes  fair  value  measurements  by  level  at  December  31,  for  assets 
measured at fair value on a recurring basis: 

Level 1

Level 2

Level 3

Total

2018

Fixed maturity securities available for sale
Obligations of government-sponsored

enterprises

U.S. Treasury securities and obligations
of U.S. government instrumentalities

Obligations of the Commonwealth of 

Puerto Rico and its instrumentalities

Municipal securities
Corporate bonds
Residential agency mortgage-backed securities
Collaterized mortgage obligations

Total fixed maturities

$                 
-

$           

21,589

$             
-

$           

21,589

177,024

-

-
-
-
-
-
177,024

$      

8,295
709,779
195,570
76,671
10,474
1,022,378

$      

-

-
-
-
-
-

177,024

8,295
709,779
195,570
76,671
10,474
1,199,402

$      

$        
-

Equity investments

$      

147,348

$         

128,011

$     

3,805

$         

279,164

Level 1

Level 2

Level 3

Total

2017

Securities available for sale
Fixed maturity securities

Obligations of government-sponsored

enterprises

U.S. Treasury securities and obligations
of U.S. government instrumentalities

Obligations of the Commonwealth of 

Puerto Rico and its instrumentalities

Municipal securities
Corporate bonds
Residential agency mortgage-backed securities
Collaterized mortgage obligations

Total fixed maturities

$                 
-

$             

1,444

$             
-

$             

1,444

118,349

-

-
-
-
-
-
118,349

$      

8,093
800,790
234,324
32,112
21,676
1,098,439

$      

-

-
-
-
-
-

118,349

8,093
800,790
234,324
32,112
21,676
1,216,788

$      

$        
-

Equity securities

$      

193,159

$         

149,149

$        
-

$         

342,308

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 use previously 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 models used by independent pricing service 
providers  to  prepare  evaluations  apply  available  information,  such  as  benchmark  curves, 
benchmarking of like securities, sector groupings, and matrix pricing.  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 
service providers 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.  

69 

 
  
 
 
 
Triple-S Management Corporation and Subsidiaries  
Notes to Consolidated Financial Statements 
December 31, 2018, 2017, and 2016 
(dollar amounts in thousands) 

In addition to the preceding disclosures on assets recorded at fair value in the consolidated balance 
sheets,  accounting  guidance  also  requires  the  disclosure  of  fair  values  for  certain  other  financial 
instruments  for  which  it  is  practicable  to  estimate  fair  value,  whether  or  not  such  values  are 
recognized in the consolidated balance sheets. 

Non-financial instruments such as property and equipment, other assets, deferred income taxes and 
intangible assets, and certain financial instruments such as claim liabilities are excluded from the fair 
value  disclosures.  Therefore,  the  fair  value  amounts  cannot  be  aggregated  to  determine  our 
underlying economic value. 

The carrying amounts reported in the consolidated balance sheets for cash and cash equivalents, 
receivables,  accounts  payable and  accrued  liabilities,  and short-term borrowings  approximate fair 
value because of the short-term nature of these items.  These assets and liabilities are not listed in 
the table below. 

The following methods, assumptions and inputs were used to estimate the fair value of each class 
of financial instrument: 

(i)  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. 

(ii)  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. 

(iii)  Long-term Borrowings  

The carrying amount of the loans payable to bank – variable approximates fair value due to its floating 
interest-rate structure.  The fair value of the loans payable to bank – fixed and senior unsecured notes 
payable was determined using broker quotations. 

70 

 
 
 
Triple-S Management Corporation and Subsidiaries  
Notes to Consolidated Financial Statements 
December 31, 2018, 2017, and 2016 
(dollar amounts in thousands) 

A summary of the carrying value and fair value by level of financial instruments not recorded at fair 
value on our consolidated balance sheets at December 31 are as follows: 

Assets:

Policy loans

Liabilities:

Policyholder deposits
Long-term borrowings:

Carrying
Value

2018

Fair Value

Level 1

Level 2

Level 3

Total

$       

9,469

$              
-

$       

9,469

$              
-

$       

9,469

$    

174,110

$              
-

$    

174,110

$              
-

$    

174,110

Loans payable to bank - variable

Total liabilities

29,114
203,224

$    

$              
-

29,114
203,224

$    

-
$              
-

29,114
203,224

$    

Assets:

Policy loans

Liabilities:

Policyholder deposits
Long-term borrowings:

Carrying
Value

2017

Fair Value

Level 1

Level 2

Level 3

Total

$       

9,077

$              
-

$       

9,077

$              
-

$       

9,077

$    

176,534

$              
-

$    

176,534

$              
-

$    

176,534

Loans payable to bank - variable

Total liabilities

32,350
208,884

$    

-
$              
-

32,350
208,884

$    

-
$              
-

32,350
208,884

$    

71 

 
 
 
 
Triple-S Management Corporation and Subsidiaries  
Notes to Consolidated Financial Statements 
December 31, 2018, 2017, and 2016 
(dollar amounts in thousands) 

11.  Claim Liabilities and Claim Adjustment Expenses 

A reconciliation of the beginning and ending balances of claim liabilities in 2018, 2017 and 2016 is 
as follows: 

2018
Other 
Business 
Segments *

Managed 
Care

Consolidated

Claim liabilities at beginning of year
Reinsurance recoverable on claim liabilities

$        

367,357
-

$        

739,519
(633,099)

$     

1,106,876
(633,099)

Net claim liabilities at beginning of year

367,357

106,420

473,777

Claims incurred

Current period insured events
Prior period insured events

Total

Payments of losses and loss-adjustment

expenses

Current period insured events
Prior period insured events

Total

Net claim liabilities at end of year
Reinsurance recoverable on claim liabilities

2,308,516
(36,015)

2,272,501

1,982,372
263,260

2,245,632

394,226
-

103,368
120,961

224,329

57,260
46,469

103,729

227,020
315,543

2,411,884
84,946

2,496,830

2,039,632
309,729

2,349,361

621,246
315,543

Claim liabilities at end of year

$        

394,226

$        

542,563

$        

936,789

72 

 
 
 
Triple-S Management Corporation and Subsidiaries  
Notes to Consolidated Financial Statements 
December 31, 2018, 2017, and 2016 
(dollar amounts in thousands) 

2017
Other 
Business 
Segments *

Managed 
Care

Consolidated

Claim liabilities at beginning of year
Reinsurance recoverable on claim liabilities

$        

349,047
-

$        

138,896
(38,998)

$        

487,943
(38,998)

Net claim liabilities at beginning of year

349,047

99,898

448,945

Claims incurred

Current period insured events
Prior period insured events

Total

Payments of losses and loss-adjustment

expenses

Current period insured events
Prior period insured events

Total

Net claim liabilities at end of year
Reinsurance recoverable on claim liabilities

2,231,052
(12,782)

2,218,270

118,012
(8,975)

109,037

2,349,064
(21,757)

2,327,307

1,940,410
259,550

2,199,960

367,357
-

64,051
38,536

102,587

106,348
633,171

2,004,461
298,086

2,302,547

473,705
633,171

Claim liabilities at end of year

$        

367,357

$        

739,519

$     

1,106,876

73 

 
 
Triple-S Management Corporation and Subsidiaries  
Notes to Consolidated Financial Statements 
December 31, 2018, 2017, and 2016 
(dollar amounts in thousands) 

2016
Other 
Business 
Segments *

Managed 
Care

Consolidated

Claim liabilities at beginning of year
Reinsurance recoverable on claim liabilities

$        

348,297
-

$        

143,468
(40,714)

$        

491,765
(40,714)

Net claim liabilities at beginning of year

348,297

102,754

451,051

Claims incurred

Current period insured events
Prior period insured events

Total

Payments of losses and loss-adjustment

expenses

Current period insured events
Prior period insured events

Total

Net claim liabilities at end of year
Reinsurance recoverable on claim liabilities

2,356,594
(9,047)

2,347,547

103,049
(7,157)

95,892

2,459,643
(16,204)

2,443,439

2,083,552
263,245

2,346,797

349,047
-

58,091
40,657

98,748

99,898
38,998

2,141,643
303,902

2,445,545

448,945
38,998

Claim liabilities at end of year

$        

349,047

$        

138,896

$        

487,943

* Other Business Segments include the Life Insurance and Property and Casualty segments,

as well as intersegment eliminations.

The actual amounts of claims incurred in connection with insured events occurring in a prior period 
typically differ from estimates of such claims made in the prior period.  Amounts included as incurred 
claims for prior period insured events reflect the aggregate net amount of these differences.   

The unfavorable developments in the claims incurred and loss-adjustment expenses for prior period 
insured  events  in  2018  is  driven  by  an  adverse  development  of  approximately  $128,678  in  the 
Property  and  Casualty  segment  losses  related  to  Hurricane  Maria,  partially  offset  by  better  than 
expected utilization trends in the Managed Care segment.  The favorable developments in the claims 
incurred  and  loss-adjustment  expenses  for  prior  period  insured  events  for  2017  and  2016  are 
primarily due to better than expected utilization trends in the Managed Care segment.  Reinsurance 
recoverable  on  unpaid  claims  is  reported  within  the  premium  and  other  receivables,  net  in  the 
accompanying consolidated financial statements.  

The claims incurred disclosed in this table exclude the portion of the change in the liability for future 
policy benefits amounting to $30,783, $25,794, and $28,752 that is included within the consolidated 
claims incurred during the years ended December 31, 2018, 2017 and 2016, respectively. 

The following is information about incurred and paid claims development, net of reinsurance, as of 
December  31,  2018,  as  well  as  cumulative  claim  frequency.    Additional  information  presented 
includes total incurred-but-not-reported liabilities plus expected development on reported claims is 
included within the net incurred claims amounts.  

74 

 
  
Triple-S Management Corporation and Subsidiaries  
Notes to Consolidated Financial Statements 
December 31, 2018, 2017, and 2016 
(dollar amounts in thousands) 

The information about incurred and paid claims development for the year ended December 31, 2015 
and previous years are presented as supplementary information and are unaudited where indicated. 
The  average  annual  percentage  payout  of  incurred  claims  by  age  as  of  December  31,  2018,  is 
presented as required supplementary information.   

Managed Care 

The  Company  estimates  its  liabilities  for  unpaid  claims following  a  detailed  actuarial  process  that 
entails  using  both  historical  claim  payment  patterns  as  well  as  emerging  medical  cost  trends  to 
project  a  best  estimate  of  claim  liabilities.  This  process  includes  comparing  the  historical  claims 
incurred dates to the actual dates on claims payment.  Completion factors are applied to claims paid 
through the consolidated financial statements date to estimate the claim expense incurred for the 
current  period.    The  liability  for  claim  adjustment  expenses  consists  of  adjustments  made  by  our 
actuaries  based  on  their  knowledge  and  their  estimate  of  emerging  impacts  to  benefit  costs  and 
payment speed. 

Incurred Claims and Allocated Claim 
Adjustment Expenses, Net of Reinsurance

As of December 31, 2018

Incurred Year

2017

2017

2018

$                         

2,231,052

2018

2,216,578

2,308,516

Total

$           

4,525,094

Total of IBNR Liabilities 
Plus Expected 
Development on 
Reported Claims

(in thousands)

Cumulative 
Number of 
Reported Claims

65,459

325,857

17,652

18,259

Cumulative Paid Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance

Incurred Year

2017

2018

2017

$                       

1,940,410

2018

2,151,406

1,982,372

Total

$           

4,133,778

All outstanding liabilities before 2017, net of reinsurance

2,910

Liabilities for claims and claim adjustment expenses, net of reinsurance

$              

394,226

75 

 
 
 
 
            
                 
            
                 
             
             
Triple-S Management Corporation and Subsidiaries  
Notes to Consolidated Financial Statements 
December 31, 2018, 2017, and 2016 
(dollar amounts in thousands) 

Property and Casualty 

Claims liability for property and casualty represents individual case estimates for reported claims and 
estimates  for  unreported  losses,  net  of  any  salvage  and  subrogation  based  on  past  experience 
modified for current trends and estimates of expense for investigating and setting claims. 

All Lines
in thousands

Incurred 
Year

2009

2010

2011

2012

2013

2014

2015

2016

2017

2018

Incurred Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance

(unaudited) (unaudited) (unaudited) (unaudited) (unaudited) (unaudited) (unaudited)

Incurred amount

2009

2010

2011

2012

2013

2014

2015

2016

2017

2018

As of December 31, 2018

Total of IBNR Plus 
Expected Development 
on Reported Claims

Cumulative Number 
of reported claims

51,778

51,760

54,226

50,848

54,090

51,315

51,298

55,266

50,287

49,040

51,564

56,400

51,105

49,856

52,343

51,315

57,115

50,776

48,900

51,030

48,430

51,485

57,386

51,895

49,817

49,606

45,410

45,067

51,293

57,242

52,099

48,945

49,168

43,707

40,175

48,127

51,563

$      

51,439

$                                

99

56,960

51,729

48,186

48,229

42,547

37,271

44,294

60,694

56,981

51,684

47,731

47,550

41,457

35,505

41,168

187,376

40,619

Total

$    

601,510

135

168

392

785

916

1,094

2,788

15,519

15,563

16,089

18,012

20,919

20,217

22,360

22,044

20,069

19,397

47,415

15,876

Incurred 
Year

2009

2010

2011

2012

2013

2014

2015

2016

2017

2018

Cumulative Paid claims and Allocated Claim Adjustment Expenses, Net of Reinsurance

(unaudited) (unaudited) (unaudited) (unaudited) (unaudited) (unaudited) (unaudited)

2009

2010

2011

2012

2013

2014

2015

2016

2017

2018

23,843

35,327
27,118

41,810
38,964
24,534

45,838
45,409
34,835
22,677

48,637
49,808
41,606
33,620
21,376

49,709
52,890
44,996
40,406
33,249
18,752

50,196
54,027
47,908
43,663
38,979
28,657
17,063

50,371
54,996
49,598
45,607
42,840
33,809
24,935
20,099

50,594
55,715
50,457
46,094
44,252
36,875
28,040
28,996
28,414

All outstanding liabilities before 2009, net of reinsurance     

$    

50,680
56,253
50,761
46,441
45,234
37,857
30,729
32,820
41,855
16,555

$  

409,185
1,623

Liabilities for claims and claims adjustment expenses, net of reinsurance     

$  

193,948

The  following  table  includes  the  annual  percentage  payout  of  incurred  claims  by  age,  net  of 
reinsurance, for property and casualty segment as supplementary information as of December 31, 
2018: 

(unaudited) (unaudited) (unaudited) (unaudited) (unaudited) (unaudited) (unaudited) (unaudited) (unaudited) (unaudited)

2009

2010

2011

2012

2013

2014

2015

2016

2017

Average

43.2%

20.6%

11.7%

7.4%

4.3%

2.1%

1.3%

0.7%

0.7%

2018

0.2%

76 

 
 
 
 
 
 
 
 
 
       
       
       
       
       
       
       
       
       
                        
       
       
       
       
       
       
       
       
        
                                
                        
       
       
       
       
       
       
       
        
                                
                        
       
       
       
       
       
       
        
                                
                        
       
       
       
       
       
        
                                
                        
       
       
       
       
        
                                
                        
       
       
       
        
                              
                        
       
       
        
                              
                        
       
      
                            
                        
        
                            
                        
      
      
      
      
      
      
      
      
      
      
      
      
      
      
      
      
      
      
      
      
      
      
      
      
      
      
      
      
      
      
      
      
      
      
      
      
      
      
      
      
      
      
      
      
      
      
      
      
      
      
      
      
      
      
        
Triple-S Management Corporation and Subsidiaries  
Notes to Consolidated Financial Statements 
December 31, 2018, 2017, and 2016 
(dollar amounts in thousands) 

The reconciliation of the net incurred and paid claims development tables, by segment, to the liability 
for claims and claim adjustment expenses in the consolidated balance sheets is as follows: 

Net outstanding liabilities

Managed Care
Property and Casualty
Other short-duration insurance lines

Liabilities for unpaid claims and claim

adjustment expenses, net of reinsurance

Reinsurance recoverable on unpaid
claims - Property and Casualty

Insurance lines other than short-duration
Intersegment elimination
Total gross liability for unpaid claims and
claim adjustment expense

As of December 31, 2018

$                       

394,226
193,948
3,655

591,829

302,928

42,502
(470)

$                       

936,789

Claim liabilities as of December 31, 2018 and 2017 include approximately $415,900 and $605,200, 
respectively, of gross losses related to the impact of Hurricanes Irma and Maria which made landfall 
in Puerto Rico in September 2017.   

12.  Federal Employees’ Health Benefits (FEHBP) and Federal Employees’ (FEP) Programs 

FEHBP 

In  prior  years,  TSS  entered  into  a  contract,  renewable  annually,  with  the  Office  of  Personnel 
Management  (OPM)  as  authorized  by  the  Federal  Employees’  Health  Benefits  Act  of  1959,  as 
amended,  to  provide  health  benefits  under  the  FEHBP.    The  FEHBP  covers  postal  and  federal 
employees residing in the Commonwealth of Puerto Rico and the USVI as well as retirees and eligible 
dependents.    The  FEHBP  is  financed  through  a  negotiated  contribution  made  by  the  federal 
government and employees’ payroll deductions. 

The accounting policies for the FEHBP are the same as those described in the Company’s summary 
of significant accounting policies.  Premium rates are determined annually by TSS and approved by 
the federal government.  Claims are paid to providers based on the guidelines determined by the 
federal government.  Operating expenses are allocated from TSS’s operations to the FEHBP based 
on applicable allocation guidelines (such as, the number of claims processed for each program) and 
are subject to contractual expense limitations. 

The operations of the FEHBP do not result in any excess or deficiency of revenue or expense as this 
program has a special account available to compensate any excess or deficiency on its operations 
to  the  benefit  or  detriment  of  the  federal  government.    Any  transfer  to/from  the  special  account 
necessary  to  cover  any  excess  or  deficiency  in  the  operations  of  the  FEHBP  is  recorded  as  a 
reduction/increment to the premiums earned.  The contract with OPM provides that the cumulative 
excess  of  the  FEHBP  earned  income  over  health  benefits  charges  and  expenses  represents  a 

77 

 
 
                         
                             
                         
                         
                           
                              
Triple-S Management Corporation and Subsidiaries  
Notes to Consolidated Financial Statements 
December 31, 2018, 2017, and 2016 
(dollar amounts in thousands) 

restricted  fund  balance  denoted  as  the  special  account.    Upon  termination  of  the  contract  and 
satisfaction of all the FEHBP’s obligations, any unused remainder of the special reserve would revert 
to the Federal Employees Health Benefit Fund.  In the event that the contract terminates and the 
special reserve is not sufficient to meet the FEHBP’s obligations, the FEHBP contingency reserve 
will  be  used  to  meet  such  obligations.    If  the  contingency  reserve  is  not  sufficient  to  meet  such 
obligations, the Company is at risk for the amount not covered by the contingency reserve. 

The contract with OPM allows for the payment to the Company of service fees as negotiated between 
TSS and OPM.   

The Company also has funds available related to the FEHBP amounting to $60,959 and $68,425 as 
of December 31, 2018 and 2017, respectively, and are included within cash and cash equivalents in 
the  accompanying  consolidated  balance  sheets.    Such  funds  are  used  to  cover  health  benefits 
charges, administrative expenses and service charges required by the FEHBP. 

A  contingency  reserve  is  maintained  by  the  OPM  at  the  U.S. Treasury,  and  is  available  to  the 
Company  under  certain  conditions  as  specified  in  government  regulations.    Accordingly,  such 
reserve  is  not  reflected  in  the  consolidated  balance  sheets.    The  balance  of  such  reserve  as  of 
December 31, 2018 and 2017 was $62,911 and $32,928, respectively.  The Company received $27 
and $6,687, of payments made from the contingency reserve fund of OPM during 2017 and 2016, 
respectively.  The Company did not receive contingency reserve payments during 2018.  During the 
year  ended  December  31,  2018  the  Company  returned  excess  reserves  of  $23,030  to  the 
contingency reserve fund. 

The  claim  payments  and  operating  expenses  charged  to  the  FEHBP  are  subject  to  audit  by  the 
U.S. government.  Management is of the opinion that an adjustment, if any, resulting from such audits 
will not have a significant effect on the accompanying consolidated financial statements.  The claim 
payments  and  operating  expenses  reimbursed  in  connection  with  the  FEHBP  have  been  audited 
through 2011 by OPM. 

FEP 

In prior years, TSS entered into a contract with the BCBSA as per Contract No. C.S. 1039 with OPM 
to provide health benefits under one Government-wide Service Benefit Plan as contemplated in Title 
5,  Chapter  89,  United  States  Code.  The  FEP  covers  employees  and  annuitants  residing  in  the 
Commonwealth of Puerto Rico and the USVI as well as eligible dependents. The FEP is financed 
through  a  negotiated  contribution  made  by  the  federal  government  and  employees’  payroll 
deductions.    The  accounting  methodology  and  operations  of  the  FEP  are  similar  to  those  of  the 
FEHBP as described before. 

The claims payments and operating expenses charged to the FEP are subject to audit by the BCBSA. 
Management is of the opinion that the adjustments, if any, resulting from such audits will not have a 
significant  effect  in  the  accompanying  consolidated  financial  statements.  Operating  expenses 
reimbursed in connection with the FEP have been audited through 2013 by BCBSA. 

78 

 
 
   
 
 
 
Triple-S Management Corporation and Subsidiaries  
Notes to Consolidated Financial Statements 
December 31, 2018, 2017, and 2016 
(dollar amounts in thousands) 

13.  Long-Term Borrowings 

A summary of the borrowings entered by the Company as of December 31 is as follows:  

Secured loan payable of $11,187, payable in monthly
installments of $137 through October 1, 2023, plus 
interest at a rate reset periodically of 100 basis 
points over selected LIBOR maturity (which was 
3.35% at December 31, 2018).

Secured loan payable of $20,150, payable in monthly
installments of $84 through January 1, 2024, plus 
interest at a rate reset periodically of 275 basis 
points over selected LIBOR maturity (which was 
5.15% at December 31, 2018).

Secured loan payable of $4,116, payable in monthly
installments of $49 through January 1, 2024, plus 
interest at a rate reset periodically of 325 basis 
points over selected LIBOR maturity (which was 
5.65% at December 31, 2018).

Total borrowings

Less: unamortized debt issuance costs

2018

2017

$      

7,907

$      

9,547

18,218

19,226

2,989

29,114

231

3,577

32,350

277

$     

28,883

$     

32,073

Aggregate maturities  of the Company’s borrowings as of December 31, 2018  are summarized as 
follows: 

Year ending December 31
2019
2020
2021
2022
2023
Thereafter

$      

3,236
3,236
3,236
3,236
2,942
13,228

$     

29,114

On  December  28,  2016,  TSM  entered  into  a  $35,500  credit  agreement  with  a 
commercial bank in Puerto Rico. The agreement consists of three term loans: (i) Term Loan A in the 
principal amount of $11,187, (ii) Term Loan B in the principal amount of $20,150 and (iii) Term Loan 
C in the principal amount of $4,116. Term Loan A matures in October 2023 while the Term Loans B 
and C mature in January 2024.  Term Loan A was used to refinance a previous $41,000 secured 
loan payable with the same commercial bank.  Proceeds from Term Loans B and C were received 
on January 11, 2017 and were used to prepay the outstanding principal amount plus accrued interest 
of the 6.6% Senior Unsecured Notes due December 2020 ($24,000) and fund a portion of a debt 
service reserve for the loan (approximately $200).  Interest payable commenced on January 1, 2017, 
in the case of Term Loan A, and on February 1, 2017, in the case of Term Loan B and Term Loan 

79 

 
  
 
 
   
 
Triple-S Management Corporation and Subsidiaries  
Notes to Consolidated Financial Statements 
December 31, 2018, 2017, and 2016 
(dollar amounts in thousands) 

C.  The Credit Agreement includes certain financial and non-financial covenants, including negative 
covenants  imposing  certain  restrictions  on  the  Corporation’s  business.    The  Company  was  in 
compliance with all these covenants as of December 31, 2018.  

This credit agreement is guaranteed by a first mortgage held by the bank on the Company’s land, 
building, and substantially all leasehold improvements, as collateral for the term of the loan under a 
continuing general security agreement.   

The  Company  may,  at  its  option,  upon  notice,  as  specified  in  the  credit  agreement,  redeem  and 
prepay  prior  to  maturity,  all  or  any  part  of  the  loan  and  from  time  to  time  upon  the  payment  of  a 
penalty fee of 3% during the first year, 2% during the second year and 1% during the third year, and 
thereafter, at par, as specified in the credit agreement, together with accrued and unpaid interest, if 
any, to the date of redemption specified by the Company. 

Interest expense on the above borrowings amounted to $1,375, $1,196, and $1,763, for the years 
ended December 31, 2018, 2017, and 2016, respectively. 

On April 18, 2017, TSA entered into a $10,000 revolving loan agreement with a commercial bank in 
Puerto Rico. This line of credit has an interest rate of 30-day LIBOR plus 25 basis points and contains 
certain financial and non-financial covenants that are customary for this type of facility. This line of 
credit had an original maturity date of April 17, 2018 and was renewed for an additional year, maturing 
on April 30, 2019.     

14.  Reinsurance Activity 

The effect of reinsurance on premiums earned and claims incurred is as follows: 

2018

Premiums Earned
2017

2016

2018

Claims Incurred(1)
2017

2016

Gross
Ceded
Assumed
Net

$  

3,009,830
(73,591)
2,352
2,938,591

$   

$   

$   

2,893,765
(71,295)
4,462
2,826,932

$   

$   

2,945,017
(59,032)
4,656
2,890,641

$  

2,657,639
(163,898)
3,089
2,496,830

$   

$   

$   

3,010,728
(687,520)
4,099
2,327,307

$   

$   

2,454,758
(15,008)
3,689
2,443,439

(1)  The claims incurred disclosed in this table exclude the portion of the change in 
the liability for future policy benefits amounting to $30,783, $25,794, and $28,752 
that is included within the consolidated claims incurred during the years ended 
December 31, 2018, 2017 and 2016, respectively. 

TSS,  TSA,  TSP  and  TSV,  in  accordance  with  general  industry  practices,  annually  purchase 
reinsurance  to  protect  them from  the  impact  of  large  unforeseen  losses  and  prevent  sudden  and 
unpredictable  changes  in  net  income  and  stockholders’  equity  of  the  Company.    Reinsurance 
contracts do not relieve any of the subsidiaries from their obligations to policyholders.  In the event 
that all or any of the reinsuring companies might be unable to meet their obligations under existing 
reinsurance agreements, the subsidiaries would be liable for such defaulted amounts.  During 2018, 
2017,  and  2016  TSP  placed  16.45%,  14.88%,  and  13.16%  of  its  reinsurance  business  with  one 
reinsurance company.   

80 

 
 
       
     
          
          
Triple-S Management Corporation and Subsidiaries  
Notes to Consolidated Financial Statements 
December 31, 2018, 2017, and 2016 
(dollar amounts in thousands) 

TSS  has  excess  of  loss  reinsurance  treaties  whereby  it  cedes  a  portion  of  its  premiums  to  third 
parties.  Reinsurance contracts are primarily for periods of one year and are subject to modifications 
and negotiations at each renewal date.  Premiums ceded under these contracts amounted to $1,524, 
$2,168, and $3,148 in 2018, 2017 and 2016, respectively.  Claims ceded amounted to $320, $463, 
and  $1,700,  in  2018,  2017  and  2016,  respectively.    Principal  reinsurance  agreements  include  an 
organ transplant excess of loss treaty, which covers: 

•  For group policies, 80% of the claims up to a maximum of $800 (80% of $1,000), per person, per 
life. For other group policies with other options, the agreement covers 80% of the claims up to a 
maximum of $400 (80% of $500), per person, per life, or 80% of the claims up to a maximum of 
$200 (80% of $250), per person, per life.  

•  For policies provided to the active and retired employees of the Commonwealth of Puerto Rico 
and its instrumentalities, the treaty covers 100% of the claims up to a maximum of $1,000 per 
person, per life with major medical coverage, only if the covered person uses providers that are 
members of TSS network.  

•  For policies provided to the municipalities of Puerto Rico, the treaty covers 100% of the claims 
up to a maximum of $250, per person, per life, with plans with lifetime limits and all other plans 
100% of the claims up to a maximum of $1,000, per person, per life. 

TSA has an excess of loss reinsurance treaty whereby it cedes a portion of its premiums to a third 
party.    This  reinsurance  contract  is  for  a  period  of  one  year  and  is  subject  to  modifications  and 
negotiations in each renewal date.  Premiums ceded under this contract amounted to $2,300 and 
$1,224, in 2018 and 2017, respectively. Claims ceded amounted to $1,804 and $1,360, in 2018 and 
2017, respectively.  This reinsurance agreement includes an excess of loss reinsurance coverage for 
certain  hospital  inpatient,  hospital  outpatient,  ambulance,  and  physician  services  as  well  as 
pharmaceutical drugs. This agreement covers a maximum of $2,000 per person, per agreement term. 

TSP utilized facultative reinsurance, pro rata, and excess of loss reinsurance treaties to manage its 
exposure  to  losses,  including  those  from  catastrophe  events.    TSP  has  geographic  exposure  to 
catastrophe losses from hurricanes and earthquakes.  The incidence and severity of catastrophes 
are  inherently  unpredictable.   Under  these  treaties,  TSP  ceded  premiums  written  were  $60,354, 
$62,268, and $45,957, in 2018, 2017, and 2016, respectively. In 2018 and 2017, TSP ceded claims 
incurred amounting to $152,704 and $678,624, respectively, related to losses caused by Hurricanes 
Irma and Maria. 

During  2018,  as  part  of  the  catastrophe  program,  TSP  signed  a  multiyear  reinsurance  contract 
providing for retroactive and prospective reinsurance coverage.  The retroactive coverage resulted in 
a deferred gain on retroactive reinsurance of $25,000 as of December 31, 2018, which is presented 
within the accounts payable and accruals in the accompanying consolidated balance sheets.  The 
deferred  gain  on  the  retroactive  reinsurance  will  be  amortized  using  the  recovery  method.    The 
recovery method provides for the amortization in proportion to the estimated recoveries made as of 
the reporting date as a percentage of total estimated recoveries. 

Ceded  unearned  reinsurance  premiums  arising  from  TSP  reinsurance  transactions  amounted  to 
$11,760 and $12,393 as of December 31, 2018 and 2017, respectively, and are reported as other 
assets in the accompanying consolidated balance sheets. 

81 

 
Triple-S Management Corporation and Subsidiaries  
Notes to Consolidated Financial Statements 
December 31, 2018, 2017, and 2016 
(dollar amounts in thousands) 

Most principal reinsurance contracts are for a period of one year and are subject to modifications 
and  negotiations  in  each  renewal.    Current  property  and  catastrophe  reinsurance  program  was 
renewed effective April 1, 2018 for the twelve-month period ending March 31, 2019.  Other contracts 
were renewed as expiring on January 1, 2019. 

Principal reinsurance agreements are as follows: 

•  Casualty  excess  of  loss  treaty  provides  reinsurance  for  losses  up  to  $12,000,  subject  to  a 

retention of $225. 

•  Medical malpractice excess of loss treaty provides reinsurance for losses up to $3,000, subject 

to a retention of $150.  

•  Property reinsurance treaty includes proportional cessions and a per risk excess of loss contract 

limiting losses to $325 in $30,000 risks.  

•  Catastrophe  protection  is  purchased  limiting  losses  to  $10,000  per  event  with  losses  up  to 

approximately $915,000.   

TSV also cedes insurance with various reinsurance companies under a number of pro rata, excess 
of loss and catastrophe treaties. Under these treaties, TSV ceded premiums of $8,780, $8,826, and 
$8,838, in 2018, 2017, and 2016, respectively. Principal reinsurance agreements are as follows: 

•  Group life insurance facultative agreement, reinsuring risk in excess of $25 of certain group life 
policies and a combined pro rata and excess of loss agreement effective July 1, 2008, reinsuring 
50% of the risk up to $200 and ceding the excess. 

• 

• 

• 

Facultative  pro  rata  agreements for  the  long-term  disability  insurance,  reinsuring  65%  of  the 
risk. 

Several reinsurance agreements, mostly on an excess of loss basis up to a maximum retention 
of $200. 

Excess of loss agreement for the major medical business in Costa Rica reinsuring 100% of all 
claims over $35. 

TSV participates in various retrocession reinsurance agreements. The retrocessions are based on 
group life and health reinsurance business pools for which TSV has participations ranging from 6.7% 
to  10%  of  the  total  reinsurance  facility.  TSV  share  of  the  reinsurer’s  gross  liability  is  limited  to  a 
maximum  that  ranges  depending  on  the  agreement  from  $50  to  $500  per  covered  life.  The 
agreements cover new and renewal business for a period of twelve months and may be cancelled 
subject to ninety days written notice at any anniversary date. 

82 

 
 
 
Triple-S Management Corporation and Subsidiaries  
Notes to Consolidated Financial Statements 
December 31, 2018, 2017, and 2016 
(dollar amounts in thousands) 

15. 

Income Taxes  

The  Company  and  its  subsidiaries  are  subject  to  Puerto  Rico  income  taxes.  Under  Puerto  Rico 
income tax law, the Company is not allowed to file consolidated tax returns with its subsidiaries. The 
Company’s insurance subsidiaries are also subject to U.S. federal income taxes for foreign source 
dividend income.  The Company is potentially subject to income tax audits in the Commonwealth of 
Puerto Rico for the taxable year 2015 and after, until the applicable statute of limitations expires. Tax 
audits by their nature are often complex and can require several years to complete. 

Managed  Care  and  Property  and  Casualty  corporations  are  taxed  essentially  the  same  as  other 
corporations,  with  taxable  income  primarily  determined  on  the  basis  of  the  statutory  annual 
statements filed with the insurance regulatory authorities. The corporations are also subject to an 
alternative minimum income tax, which is calculated based on the formula established by existing 
tax laws. Any alternative minimum income tax paid may be used as a credit against the excess, if 
any, of regular income tax over the alternative minimum income tax in future years up to a limit of 
25% of the excess. 

The  Company,  through  one  of  its  Managed  Care  corporations,  has  a  branch  in  the  USVI  that  is 
subject  to  a  5%  premium  tax  on  policies  underwritten  therein.  As  a  qualified  foreign  insurance 
company, the Company is subject to income taxes in the USVI, which has implemented a mirror tax 
law based on the U.S. Internal Revenue Code.  The branch operations in the USVI had certain net 
operating losses for USVI tax purposes for which a valuation allowance has been recorded.  

Companies  within  our  Life  Insurance  segment  operate  as  qualified  domestic  life  insurance 
companies and are subject to the alternative minimum tax and taxes on its capital gains.  

On December 22, 2017, U.S Government enacted PL 115-97, better known as the Tax Cut and Jobs 
Act (TCJA). The TCJA incorporates a series of changes in tax rates at the federal level applicable 
for taxable years beginning after December 31, 2017 and before January 1, 2026.  The U.S. federal 
maximum corporate income tax rate is reduced from 35% to a 21% flat rate, this change did not have 
a significant impact for the Company and its insurance subsidiaries are only taxed in that jurisdiction 
for passive income earned on investments, which continue to be subject to withholding at source at 
its gross level. In addition,  the TCJA incorporates restrictions on  insurance business exception to 
passive  foreign  investment  company  (PFIC)  rules,  that  were  taxed  under  the  PFIC’s  earnings, 
subject to an exception for certain income derived in the active conduct of an insurance business. At 
the  moment,  no  significant  impact  for  the  Company  has  been  identified.    We  annually  test  our 
compliance with the new guidelines for Section 1297 PFIC test, at the insurance subsidiary level.  

On December 10, 2018, the Puerto Rico Government signed in to Law by, P C 1544, better known 
as the Puerto Rico Tax Reform, now Act 257 of 2018. With this Law, additional amendments are 
incorporated to the Puerto Rico Internal Revenue Code. Approved changes include: (i) a decrease 
in the maximum corporate tax rate from 39% to 37.5%; (ii) an increase from 80% to a 90% in the 
amount of net operating loss carryover deduction available to be claimed against current year net 
income for regular tax purposes; (iii) an increase in the withholding at source for services rendered 
from 7% to 10% ; (iv) a limitation in the amounts of net operating losses generated by a corporate 
shareholder allowed to be netted against net income distributed from a flow-through investment, not 
permitted  for  taxable  years  beginning  after  December  31,  2018;  and  (v)  a  revised  large  taxpayer 
definition to include flow-through entities and extend the determination of audited financial statement 
requirements  at  the  group  level.    The  Puerto  Rico  Tax  Reform  also  adds  requirements  for  the 
deductibility  of  certain  expenses  as  well  as  disclosure  requirements  related  to  any  uncertain  tax 

83 

 
Triple-S Management Corporation and Subsidiaries  
Notes to Consolidated Financial Statements 
December 31, 2018, 2017, and 2016 
(dollar amounts in thousands) 

position  (UTP)  recorded  following  GAAP.    All  of  these  changes  are  effective  for  taxable  years 
beginning January 1, 2019.  During the year ended December 31, 2018, the Company recorded an 
additional deferred tax expense of $3,165 million related to the impact that the lower corporate tax 
rate had in our net deferred tax assets. 

Federal  income  taxes  recognized  by  the  Company’s  insurance  subsidiaries  amounted  to 
approximately $1,147, $985, and $733, in 2018, 2017, and 2016, respectively. 

All  other  corporations  within  the  group  are  subject  to  Puerto  Rico  income  taxes  as  regular 
corporations, as defined in the P.R. Internal Revenue Code, as amended. 

The components of income tax expense (benefit) consisted of the following: 

Current income tax expense
Deferred income tax benefit

$         

2,212
(32,078)

$        

34,412
(9,916)

$         

1,981
(8,326)

Total income tax (benefit) expense 

$     

(29,866)

$       

24,496

$       

(6,345)

2018

2017

2016

84 

 
 
 
 
Triple-S Management Corporation and Subsidiaries  
Notes to Consolidated Financial Statements 
December 31, 2018, 2017, and 2016 
(dollar amounts in thousands) 

The income tax (benefit) expense differs from the amount computed  by applying the  Puerto Rico 
statutory income tax rate to the income before income taxes as a result of the following:  

2018

2017

2016

(Loss) income before taxes
Statutory tax rate

$      

(93,172)
39.00% 

$        

78,977
39.00% 

$       

11,086
39.00% 

Income tax (benefit) expense at statutory rate

(36,337)

30,801

4,324

(Decrease) increase in taxes resulting from

Exempt income, net
Effect of taxing life insurance operations
as a qualified domestic life insurance
company instead of as a regular
corporation

Effect of taxing capital gains at a

preferential rate

Adjustment to deferred tax assets and
liabilities for changes in effective
tax rates

Other adjustments to deferred tax

assets and liabilities

Effect of extraordinary dividend distribution

from the JUA Association - reported net of
taxes in other income

Charges against the catastrophe loss reserve
Allowance for doubtful receivables recapture
Tax credit benefit
Tax returns to provision true up

Subtotal

Other permanent disallowances, net:

Disallowance of expenses related to exempt

interest income

Disallowed interest expense
Other

Total other permanent differences

Other adjustments

Total income tax (benefit) expense

(2,330)

(3,853)

(5,158)

(3,445)

(4,871)

(5,033)

4,819

(2,116)

(3,799)

9,217

(43)

-
-
-
(306)
(798)
7,114

(120)

836

(922)
1,567
2,688
(555)
363
(6,983)

1,669

2,852

(151)
-
-
(709)
(181)
(10,510)

-
-
(229)
(229)
(414)
(29,866)

$     

-
-
50
50
628
24,496

$       

58
8
-
66
(225)
(6,345)

$       

85 

 
  
Triple-S Management Corporation and Subsidiaries  
Notes to Consolidated Financial Statements 
December 31, 2018, 2017, and 2016 
(dollar amounts in thousands) 

Deferred income taxes reflect the tax effects of temporary differences between carrying amounts of 
assets and liabilities for financial reporting purposes and income tax purposes. The net deferred tax 
asset  at  December 31,  2018  and  2017  of  the  Company  and  its  subsidiaries  is  composed  of  the 
following:  

Deferred tax assets
Allowance for doubtful receivables
Liability for pension benefits
Postretirement benefits
Deferred compensation
Accumulated depreciation
Impairment loss on investments
Contingency reserves
Share-based compensation
Alternative minimum income tax credit
Purchased tax credits
Net operating loss
Reinsurance agreement
Accrued liabilities
Difference in tax basis of investments portfolio
Other

Gross deferred tax assets

Less: valuation allowance

Deferred tax assets

Deferred tax liabilities
Deferred policy acquisition costs
Catastrophe loss reserve
Unrealized gain on securities available for sale
Unrealized gain on equity investments
Difference in tax basis of investments portfolio
Unamortized debt issue costs
Intangible asset
Employee benefits plan

Gross deferred tax liabilities

Net deferred tax asset

2018

2017

$       

14,092
12,846
527
2,202
979
765
75
5,587
2,627
1,229
60,731
9,375
4,292
320
188

$       

11,787
13,826
662
2,168
1,296
950
1,950
6,795
1,874
2,767
38,839
-
3,271
-
873

115,835

(9,867)

105,968

(6,382)
(12,385)
(6,781)
(2,773)
-
(87)
(909)
(886)

(30,203)

87,058

(8,283)

78,775

(7,323)
(6,371)
(19,440)
-
(220)
(108)
(1,546)
(535)

(35,543)

$       

75,765

$       

43,232

The net deferred tax asset shown in the table above at December 31, 2018 and 2017 is reflected in 
the consolidated balance sheets as $79,010 and $65,123, respectively, in deferred tax assets and 
$3,245  and  $21,891,  in  deferred  tax  liabilities,  respectively,  reflecting  the  aggregate  deferred  tax 
assets or liabilities of individual tax-paying subsidiaries of the Company. 

In assessing the realizability of deferred tax assets, management considers whether it is more likely 
than not that some portion or all of the deferred tax assets will not be realized. The ultimate realization 

86 

 
 
        
Triple-S Management Corporation and Subsidiaries  
Notes to Consolidated Financial Statements 
December 31, 2018, 2017, and 2016 
(dollar amounts in thousands) 

of deferred tax assets is dependent upon the generation of future taxable income during the periods 
in which those temporary differences become deductible. Management believes that it is more likely 
than not that the Company will realize the benefits of these deductible differences.  The valuation 
allowance is mostly related to the net operating losses generated by the Company’s USVI operations 
and the health clinic’s operations based on the available evidence are not considered to be realizable 
at the reporting dates. 

At December 31, 2018, the Company and its subsidiaries have net operating loss carry-forwards for 
Puerto  Rico  income  tax  purposes  of  approximately  $176,977,  which  are  available  to  offset  future 
taxable income for up to December 2027. The carryforwards generally expire in 2026 through 2027.  
Except for the valuation allowance described  in  the  previous paragraph, the  Company concluded 
that as of December 31, 2018, it is more likely than not that the entities that have these net operating 
loss carry-forwards will generate sufficient taxable income within the applicable net operating loss 
carry-forward  periods  to  realize  its  deferred  tax  asset.  This  conclusion  is  based  on  the  historical 
results  of  each  entity,  adjusted  to  exclude  non-recurring  conditions,  and  the  forecast  of  future 
profitability.  Management will continue to evaluate, on a quarterly basis, if there are any significant 
events that will affect the Company’s ability to utilize these deferred tax assets. 

87 

 
 
 
Triple-S Management Corporation and Subsidiaries  
Notes to Consolidated Financial Statements 
December 31, 2018, 2017, and 2016 
(dollar amounts in thousands) 

16.  Pension Plans  

Non-contributory Defined-Benefit Pension Plan 
The Company sponsors a non-contributory defined-benefit pension plan for its employees and for 
the  employees  of  certain  subsidiaries.    Pension  benefits  begin  to  vest  after  five  years  of  vesting 
service, as  defined,  and are based on  years  of service and final average salary, as  defined. The 
funding policy is to contribute to the plan as necessary to meet the minimum funding requirements 
set forth in the Employee Retirement Income Security Act of 1974, as amended, plus such additional 
amounts as the Company may determine to be appropriate from time to time.  The measurement 
date used to determine pension benefit for the pension plan is December 31. 

In December 2016, the Company announced that effective January 31, 2017, it would freeze the pay 
and service amounts used to calculate pension benefits for active employees who participated in the 
pension plan. Therefore, as of the effective date, active employees in the pension plan do not accrue 
additional benefits for future service and eligible compensation received. 

The  following  table  sets  forth  the  plan’s  benefit  obligations,  fair  value  of  plan  assets,  and  funded 
status as of December 31, 2018 and 2017, accordingly: 

Change in benefit obligation
Benefit obligation at beginning of year
Service cost
Interest cost
Benefit payments
Actuarial (gain) loss
Settlements

Benefit obligation at end of year

2018

2017

$      

185,052
-
6,853
(4,466)
(18,114)
(9,848)

$      

163,877
223
7,186
(10,503)
24,269
-

$      

159,477

$      

185,052

Accumulated benefit obligation at end of year

$      

159,477

$      

185,052

Change in fair value of plan assets
Fair value of plan assets at beginning of year
Actual return on assets
Employer contributions
Settlements
Benefit payments

Fair value of plan assets at end of year

Funded status at end of year

$      

158,879
(11,608)
2,000
(9,848)
(4,466)

$      

140,398
24,984
4,000
-
(10,503)

$      

134,957

$      

158,879

$      

(24,520)

$      

(26,173)

88 

 
 
 
 
Triple-S Management Corporation and Subsidiaries  
Notes to Consolidated Financial Statements 
December 31, 2018, 2017, and 2016 
(dollar amounts in thousands) 

The  amounts  recognized  in  the  consolidated  balance  sheets  as  of  December 31,  2018  and  2017 
consist of the following:   

2018

2017

Pension liability

$       

24,520

$       

26,173

Net actuarial loss recognized in accumulated other

comprehensive loss, net of a deferred tax of $10,469 and
$10,176 in 2018 and 2017, respectively

23,691

24,540

The following assumptions were used on a weighted average basis to determine benefits obligations 
of the plan as of December 31, 2018 and 2017. 

Discount rate
Expected return on plan assets
Rate of compensation increase

2018

2017

4.50%
6.50%
N/A

3.75%
6.50%
N/A

The components of net periodic benefit cost and other amounts recognized in other comprehensive 
income for 2018, 2017, and 2016 were as follows: 

Components of net periodic benefit cost
Service cost
Interest cost
Expected return on plan assets
Prior service benefit
Actuarial loss
Settlement loss

2018

2017

2016

$                
-
6,853
(9,020)
-
961
2,110

$            

223
7,186
(8,740)
-
369
-

$         

3,640
8,749
(9,003)
(450)
4,028
-

Net periodic benefit cost

$            

904

$           

(962)

$         

6,964

2018

2017

2016

Other changes in plan assets and benefit 

obligations recognized in other 
comprehensive income

Net actuarial (gain) loss
Amortization of:

Prior service credit
Actuarial loss

$         

2,515

$         

8,024

$      

(24,628)

-
(3,071)

-
(369)

2,225
(4,028)

Total recognized in other comprehensive 

income

$           

(556)

$         

7,655

$      

(26,431)

89 

 
 
 
 
Triple-S Management Corporation and Subsidiaries  
Notes to Consolidated Financial Statements 
December 31, 2018, 2017, and 2016 
(dollar amounts in thousands) 

Net  periodic  benefit  cost  includes  settlement  charges  as  a  result  of  retirees  selecting  lump-sum 
distributions.  Settlement  charges  may  increase  in  the  future  if  the  number  of  eligible  participants 
deciding to receive distributions and the amount of their benefits increases. 

The Company recognized a pre-tax curtailment income of $1,773 during the year ended December 
31, 2016 resulting from the freezing of the plan that was effective January 31, 2017.  

The estimated net actuarial loss that will be amortized from accumulated other comprehensive loss 
into net periodic pension benefits cost during the next twelve months is $358.  

The following assumptions were used on a weighted average basis in computing the periodic benefit 
cost for the years ended December 31, 2018, 2017, and 2016: 

Discount rate
Expected return on plan assets
Rate of compensation increase

2018

2017

2016

3.75% 
6.50% 
N/A

4.50% 
6.50% 
N/A

4.75% 
7.00% 
Graded; 3.50%

to 8.00%

The basis of the overall expected long-term rate of return on assets assumption is a forward-looking 
approach based on the current long-term capital market outlook assumptions of the assets categories 
in which the trust invests and the trust’s target asset allocation. At December 31, 2018, the assumed 
target  asset  allocation  for  the  program  is:  45%  to  55%  in  equity  securities,  36%  to  44%  in  debt 
securities, and 6% to 14% in other securities. Using a mean-variance model to project returns over a 
30-year horizon under the target asset allocation, the 35 to 65 percentile range of annual rates of 
return is 5.8% to 7.2%. The Company selected a rate from within this range of 6.50% for 2018 and 
6.50% for 2017, which reflects the Company’s best estimate for this assumption based on the data 
described above, information on the historical returns on assets invested in the pension trust, and 
expected  future  conditions.  This  rate  is  net  of  both  investment  related  expenses  and  a  0.15% 
reduction for other administrative expenses charged to the trust. 

90 

 
 
 
 
Triple-S Management Corporation and Subsidiaries  
Notes to Consolidated Financial Statements 
December 31, 2018, 2017, and 2016 
(dollar amounts in thousands) 

Plan Assets 
Plan assets recorded at fair value are categorized based upon the level of judgment associated 
with the inputs used to measure their fair value. For level inputs and input definition, see note 10. 

The following table summarizes fair value measurements by level at December 31, 2018 and 2017 
for assets measured at fair value on a recurring basis:  

Government obligations
Non-agency backed securities
Corporate obligations
Limited Liability Corporations
Real estate
Registered investments
Common/Collective trusts
Common stocks
Preferred stocks
Forward foreign currency contracts
Interest-bearing cash
Derivatives

$            
-
-
-
-
-
2,328
-
1,566
6

700
-
4,600

$      

Government obligations
Non-agency backed securities
Corporate obligations
Limited Liability Corporations
Real estate
Registered investments
Hedge funds
Common stocks
Preferred stocks
Interest-bearing cash
Derivatives

-
$            
-
-
-
-
3,388
-
1,920
23
501
(1)
5,831

$      

Level 1

Level 2

Total

NAV

$     

$     

2018
Level 3

$            
-
-
-
-
-
-
-
-
-
-
-
-
$               
-

2017
Level 3

-
$            
-
-
-
-
-
-
-
-
-
-
$               
-

6,856
759
10,490
-
-
1,610
4,231
-
23
42
-
44
24,055

7,131
641
8,560
-
-
659
8,808
-
17
-
17
25,833

6,856
759
10,490
-
-
3,938
4,231
1,566
29
42
700
44
28,655

7,131
641
8,560
-
-
4,047
8,808
1,920
40
501
16
31,664

$            
-
-
-
97,660
7,975
-
1,898
-
-
-
-
-
107,533

$  

-
$            
-
-
119,581
7,568
-
1,972
-
-
-
-
129,121

$  

$    

$    

Level 1

Level 2

Total

NAV

$     

$     

$    

$    

The Company’s plan assets are invested in the National Retirement Trust. The National Retirement 
Trust  was  formed  to  provide  financial  and  legal  resources  to  help  members  of  the  BCBSA  offer 
retirement benefits to their employees. 

91 

 
  
 
 
 
             
         
             
         
             
             
     
             
     
             
             
             
             
             
     
             
             
             
             
      
      
      
             
      
             
             
      
             
      
      
      
             
             
      
             
             
           
             
           
             
           
             
           
             
         
             
             
         
             
             
           
             
           
             
             
         
             
         
             
             
      
             
      
             
             
             
             
             
   
             
             
             
             
      
      
         
             
      
             
             
      
             
      
      
      
             
             
      
             
           
           
             
           
             
         
             
             
         
             
            
           
             
           
             
Triple-S Management Corporation and Subsidiaries  
Notes to Consolidated Financial Statements 
December 31, 2018, 2017, and 2016 
(dollar amounts in thousands) 

The investment program for the National Retirement Trust is based on the precepts of capital market 
theory  that  are  generally  accepted  and  followed  by  institutional  investors,  who  by  definition  are 
long-term oriented investors. This philosophy holds that: 

• 

Increasing  risk  is  rewarded  with  compensating  returns  over  time,  and  therefore,  prudent  risk 
taking is justifiable for long-term investors. 

•  Risk can be controlled through diversification of asset classes and investment approaches, as 

well as diversification of individual securities. 

•  Risk  is  reduced  by  time,  and  over  time  the  relative  performance  of  different  asset  classes  is 
reasonably  consistent.  Over  the  long-term,  equity  investments  have  provided  and  should 
continue  to  provide  superior  returns  over  other  security  types.  Fixed-income  securities  can 
dampen volatility and provide liquidity in periods of depressed economic activity.  Lengthening 
duration of fixed income securities may reduce surplus volatility. 

•  The strategic or long-term allocation of assets among various asset classes is an important driver 

of long-term returns. 

•  Relative performance of various asset classes is unpredictable in the short-term and attempts to 

shift tactically between asset classes are unlikely to be rewarded. 

Investments will be made for the sole interest of the participants and beneficiaries of the programs 
participating  in  the  National  Retirement  Trust.  Accordingly,  the  assets  of  the  National  Retirement 
Trust shall be invested in accordance with these objectives: 

•  To  ensure  assets  are  available  to  meet  current  and  future  obligations  of  the  participating 

programs when due. 

•  To earn the maximum return that can be realistically achieved in the markets over the long-term 

at a specified and controlled level of risk in order to minimize future contributions. 

•  To invest assets with consideration of the liability characteristics in order to better align assets 

and liabilities. 

•  To  invest  the  assets  with  the  care,  skill,  and  diligence  that  a  prudent  person  acting  in  a  like 
capacity would undertake. In the process, the Administration of the Trust has the objective of 
controlling the costs involved with administering and managing the investments of the National 
Retirement Trust. 

92 

 
 
 
Triple-S Management Corporation and Subsidiaries  
Notes to Consolidated Financial Statements 
December 31, 2018, 2017, and 2016 
(dollar amounts in thousands) 

Cash Flows 
The Company expects to contribute $2,000 to its pension program in 2019. 

The following benefit payments, which reflect expected future service, as appropriate, are expected 
to be paid: 

Year ending December 31

2019
2020
2021
2022
2023
2024 – 2028

$        

9,572
9,145
9,329
9,214
9,278
49,475

Non-contributory Supplemental Pension Plan 
In addition, the Company sponsors a non-contributory supplemental pension plan. This plan covers 
employees with qualified defined benefit retirement plan benefits limited by the U.S. Internal Revenue 
Code maximum compensation and benefit limits.  At December 31, 2018 and 2017, the Company 
has recorded a pension liability of $6,754 and $7,499, respectively.  The charge to accumulated other 
comprehensive loss related to the non-contributory pension plan at December 31, 2018 and 2017 
amounted to $35 and $445, respectively, net of a deferred tax asset of $61 and $290, respectively. 

17.  Catastrophe Loss Reserve and Trust Fund 

In accordance with Chapter 25 of the Puerto Rico Insurance Code, as amended, TSP is required to 
record a catastrophe loss reserve. This catastrophe loss reserve is supported by a trust fund for the 
payment  of  catastrophe  losses.  The  reserve  increases  by  amounts  determined  by  applying  a 
contribution rate, not in excess of 5%, to catastrophe written premiums as instructed annually by the 
Commissioner of Insurance, unless the level of the reserve exceeds 8% of catastrophe exposure, as 
defined. The reserve also increases by an amount equal to the resulting return in the supporting trust 
fund  and  decreases  by  payments  on  catastrophe  losses  or  authorized  withdrawals  from  the  trust 
fund.  Additions to the catastrophe loss reserve are deductible for income tax purposes.  

This trust may invest its funds in securities authorized by the Insurance Code, but not in investments 
whose value may be affected by hazards covered by the catastrophic insurance losses. The interest 
earned on these investments and any realized gains (loss) on investment transactions are part of 
the  trust  fund  and  are  recorded  as  income  (expense)  of  the  Company.  An  amount  equal  to  the 
investment returns is recorded as an addition to the trust fund. 

During  the  year  ended  December  31,  2018,  TSP  received  the  approval  of  the  Commissioner  of 
Insurance and withdrew $10,000 from the catastrophe fund following the payment for catastrophe 
losses related to the impact of Hurricanes Irma and Maria in September 2017.   

The interest earning assets in this fund, which amounted to $38,978 and $48,363 as of December 31, 
2018 and 2017, respectively, are to be used solely and exclusively to pay catastrophe losses covered 
under policies written in Puerto Rico.  

TSP is required to contribute to the trust fund, if needed or necessary, on or before January 31 of 
the  following  year.  Contributions  are  determined  by  a  rate  determined  or  established  by  the 
Commissioner  of  Insurance  for  the  catastrophe  policies  written  in  that  year.  No  contribution  was 

93 

 
 
          
          
          
          
        
Triple-S Management Corporation and Subsidiaries  
Notes to Consolidated Financial Statements 
December 31, 2018, 2017, and 2016 
(dollar amounts in thousands) 

required for 2018 and 2017 since the level of the catastrophe reserve exceeds 8% of the catastrophe 
exposure.   

The amount in the trust fund may be withdrawn or released in the case that TSP ceases to underwrite 
risks subject to catastrophe losses. Also, authorized withdrawals are allowed when the catastrophe 
loss reserve exceeds 8% of the catastrophe exposure, as defined.   

TSP retained earnings are restricted in the accompanying consolidated balance sheets by the total 
catastrophe loss reserve balance, which as of December 31, 2018 and 2017 amounted to $37,749 
and $46,578, respectively. 

18.  Stockholders’ Equity 

a.  Common Stock 

On November 12,  2015,  the Company converted 1,426,721  issued  and outstanding Class A 
shares  into  Class  B  common  stock  purchased  pursuant  to  the  provisions  of  the  Articles  of 
incorporation  approved  by  Class  A  shareholders  at  the  time  of  the  Company’s  Initial  Public 
Offering.  

b.  Preferred Stock 

Authorized capital stock includes 100,000,000 of preferred stock with a par value of $1.00 per 
share.  As  of  December 31,  2018  and  2017,  there  are  no  issued  and  outstanding  preferred 
shares. 

c.  Liquidity Requirements 

As  members  of  the  BCBSA,  the  Company,  TSS,  and  TSA  are  required  by  membership 
standards of this association to maintain liquidity as defined by BCBSA. That is, to maintain total 
adjusted  capital  at  or  above  375%  of  Health  Risk-Based  Capital  (HRBC)  Authorized  Control 
Level (ACL) as defined by the National Association of Insurance Commissioners (NAIC) for the 
for Primary Licensee (TSM) and Larger BCBS Controlled Affiliate (TSS) and 100% HRBC ACL 
for the Smaller BCBS Controlled Affiliate (TSA). 

d.  Dividends 

As a holding company, the Company’s most significant assets are the common shares of its 
subsidiaries.  The principal sources of funds available to the Company are rental income and 
dividends from its subsidiaries, which are used to fund our debt service and operating expenses. 

The Company is subject to the provisions of the General Corporation Law of Puerto Rico, which 
restricts the declaration and payment of dividends by corporations organized pursuant to the 
laws of Puerto Rico.  These provisions provide that Puerto Rico corporations may only declare 
dividends charged to their retained earnings or, in the absence of retained earnings, net profits 
of the fiscal year in which the dividend is declared and/or the preceding fiscal year. 

The Company’s ability to pay dividends is dependent, among other factors, on its ability to collect 
cash dividends from its subsidiaries, which are subject to regulatory requirements, which may 

94 

 
Triple-S Management Corporation and Subsidiaries  
Notes to Consolidated Financial Statements 
December 31, 2018, 2017, and 2016 
(dollar amounts in thousands) 

restrict their ability to  declare and pay dividends or distributions.  In addition,  an outstanding 
secured term loan restricts our ability to pay dividends in the event of default (see note 13). 

The accumulated earnings of TSS, TSA, TSV, TSB and TSP are restricted as to the payment 
of dividends by statutory limitations applicable to domestic insurance companies. Under Puerto 
Rico insurance regulations, the regulated subsidiaries are permitted, without requesting prior 
regulatory approval, to pay dividends as long as the aggregate amount of all such dividends in 
any  calendar  year  does  not  exceed  the  lesser  of:  (i)  10%  of  its  surplus  as  of  the  end  of  the 
immediately  preceding  calendar  year;  or  (ii)  its  statutory  net  gain  from  operations  for  the 
immediately preceding calendar year (excluding realized capital gains).  Regulated subsidiaries 
will be permitted to pay dividends in excess of the lesser of such two amounts only if notice of 
its intent to declare such a dividend and the amount thereof is filed with the Commissioner of 
Insurance and such dividend is not disapproved within 30 days of its filing. As of December 31, 
2018, the dividends permitted to  be  distributed in 2019 by  the regulated subsidiaries  without 
prior  regulatory  approval  from  the  Commissioner  of  Insurance  amounted  to  approximately 
$26,000.   

19.  Stock Repurchase Programs 

The Company repurchases shares through open market transactions, in accordance with Rule 10b-
18 of the Securities Exchange Act of 1934, as amended, under repurchase programs authorized by 
the Board of Directors.  Shares purchased under share repurchase programs are retired and returned 
to authorized and unissued status. 

A summary of share repurchase programs in place during the three-year-period ended December 
31, 2018 is as follows: 

• 

• 

In November 2015 the Company’s Board of Directors authorized a $25,000 repurchase program 
(2015  $25,000  program)  of  its  Class  B  common  stock.    This  program  was  completed  on 
September 14, 2016. 

In August  2017 the Company’s  Board of Directors authorized  a $30,000 repurchase program 
(2017 $30,000 program) of its Class B common stock.  In February 2018 the Company’s Board 
of Directors authorized a $25,000 expansion of this program. 

The stock repurchase activity under stock repurchase programs for the years ended December 31 
is summarized as follows:  

2018

Average
Share
Price

Shares
Repurchased

Amount

Shares

Repurchased Repurchased

2017

Average
Share
Price

Amount

Shares

Repurchased Repurchased

2016

Average
Share
Price

Amount
Repurchased

2017  $30,000 program
2015  $25,000 program

903,888

-

$    

24.76
-

$       

22,390
-

861,415

-

$    

23.38
-

$       

20,220
-

-

951,831

-
$           
22.54

-
$                 
21,370

Total

903,888

$    

24.76

$       

22,390

861,415

$    

23.38

$       

20,220

951,831

$    

22.54

$         

21,370

95 

 
 
 
 
 
      
      
               
             
        
             
             
        
             
        
    
         
Triple-S Management Corporation and Subsidiaries  
Notes to Consolidated Financial Statements 
December 31, 2018, 2017, and 2016 
(dollar amounts in thousands) 

20.  Comprehensive Income 

The accumulated balances for each classification of other comprehensive income are as follows: 

Unrealized
Gains on
Securities

Liability
for Pension
Benefits

Accumulated
Other
Comprehensive 
Income

Beginning balance at December 31, 2017

$               

76,238

$              

(24,984)

$              

51,254

Cumulative effect adjustment due to
implementation of ASU 2016-01

Net current period change
Reclassification adjustments for gains and 

losses reclassified in income

(39,882)
(19,500)

10,452

-
1,360

(622)

(39,882)
(18,140)

9,830

Ending balance at December 31, 2018

$               

27,308

$              

(24,246)

$                

3,062

The related deferred tax effects allocated to each component of other comprehensive income in the 
accompanying consolidated statements of stockholders’ equity and comprehensive income in 2018, 
2017 and 2016 are as follows:  

2018
Deferred Tax
(Expense)
Benefit

Net-of-Tax
Amount

Before-Tax
Amount

Unrealized holding gains on securities

arising during the period

$        

(24,375)

$           

4,875

$        

(19,500)

Less reclassification adjustment for

gains and losses realized in income
Net change in unrealized gain

Liability for pension benefits:

Reclassification adjustment for

amortization of net losses from past
experience and prior service costs
Net change arising from assumptions
and plan changes and experience
Net change in liability for

13,457
(10,918)

(3,005)
1,870

10,452
(9,048)

(995)

2,190

373

(830)

(622)

1,360

pension benefits

Net current period change

1,195
(9,723)

$          

$           

(457)
1,413

738
(8,310)

$          

96 

 
 
 
Triple-S Management Corporation and Subsidiaries  
Notes to Consolidated Financial Statements 
December 31, 2018, 2017, and 2016 
(dollar amounts in thousands) 

2017
Deferred Tax
(Expense)
Benefit

Net-of-Tax
Amount

Before-Tax
Amount

Unrealized holding gains on securities

arising during the period

$         

28,544

$          

(5,708)

$         

22,836

Less reclassification adjustment for

gains and losses realized in income
Net change in unrealized gain

Liability for pension benefits:

Reclassification adjustment for

amortization of net losses from past
experience and prior service costs
Net change arising from assumptions
and plan changes and experience
Net change in liability for

(10,831)
17,713

1,862
(3,846)

(8,969)
13,867

5

(2)

3

(8,215)

3,204

(5,011)

pension benefits

Net current period change

(8,210)
9,503

$           

3,202
(644)

$             

(5,008)
8,859

$           

2016
Deferred Tax
(Expense)
Benefit

Net-of-Tax
Amount

Before-Tax
Amount

Unrealized holding gains on securities

arising during the period

$         

18,357

$          

(3,596)

$         

14,761

Less reclassification adjustment for

gains and losses realized in income
Net change in unrealized gain

Liability for pension benefits:

Reclassification adjustment for

amortization of net losses from past
experience and prior service costs
Net change arising from assumptions
and plan changes and experience
Net change in liability for

(17,379)
978

2,511
(1,085)

(14,868)
(107)

1,888

(737)

1,151

25,783

(10,055)

15,728

pension benefits

Net current period change

27,671
28,649

$         

(10,792)
(11,877)

$        

16,879
16,772

$         

97 

 
 
 
 
 
 
Triple-S Management Corporation and Subsidiaries  
Notes to Consolidated Financial Statements 
December 31, 2018, 2017, and 2016 
(dollar amounts in thousands) 

21.  Share-Based Compensation 

In December 2007, the Company adopted the 2007 Incentive Plan (the 2007 plan), which permits 
the Board to grant stock options, restricted stock awards and performance awards to eligible officers, 
directors  and  employees.  The  2007  plan  authorized  the  granting  of  up  to  4,700,000  of  Class B 
common shares of authorized but unissued stock. The 2007 plan was terminated in April 2017, when 
the 2017 Incentive Plan (the 2017 plan) was adopted.  The 2017 plan permits the Board to grant 
stock options, stock appreciation rights (SARs), restricted stock, restricted stock units, performance 
awards, and other stock-based awards, to our officers and employees.  In addition, the 2017 plan 
authorizes  the  grant  of  equity-based  compensation  incentives  to  our  directors  and  to  any 
independent contractor and consultants.  The 2017 plan authorizes the granting of up to 1,700,000 
of Class B common shares plus the number of shares that were subject to any outstanding awards 
under the 2007 plan that are forfeited, cancelled, expire, terminate or otherwise lapse, in whole or in 
part,  without  the  delivery  of  the  shares.  At  December 31,  2018,  there  were  1,286,373  shares 
available for the Company to grant under the 2017 Plan.  

Stock  options  and  SARs  can  be  granted  with  an  exercise  price,  which  shall  not  be  less  than  the 
stock’s fair market value at the grant date. The term of each stock options and SARs shall be fixed 
by the Board of Directors but shall not exceed 10 years from the date of grant.  The restricted stock, 
restricted stock units, and performance awards are issued at the fair value of the stock on the grant 
date.  Restricted stock awards and restricted stock units vest in installments, as stipulated in each 
restricted  stock  agreement.  Performance  awards  vest  on  the  last  day  of  the  performance  period, 
provided that at least minimum performance standards are achieved. 

There was no stock option activity during the years ended December 31, 2018 and 2017. There were 
4,440  exercised  options  during  2016.  No  options  were  granted  during  the  three  years  ended 
December 31, 2018, 2017 and 2016.  No cash was received from stock options exercises during the 
years ended December 31, 2018, 2017 and 2016. During the year ended December 31, 2018, 29,779 
shares  were  repurchased  and  retired  as  the  result  of  non-cash  tax  withholding  upon  vesting  of 
shares. During the year ended December 31, 2016, 2,290 shares were repurchased and retired as 
a result of non-cash exercise of stock options.  No shares were repurchased and retired as a result 
of non-cash exercise of stock options or non-cash tax withholding upon vesting of shares during year 
ended December 31, 2017. 

98 

 
 
 
Triple-S Management Corporation and Subsidiaries  
Notes to Consolidated Financial Statements 
December 31, 2018, 2017, and 2016 
(dollar amounts in thousands) 

A  summary  of  the  status  of  the  Company’s  non-vested  restricted  and  performance  shares  as  of 
December 31, 2018, and changes during the year ended December 31, 2018, are presented below: 

Restricted Awards

Weighted
Average
Fair
Value

Number of
Shares

Performance Awards
Weighted
Average
Exercise
Price

Number of
Shares

217,687
116,316
(126,483)
(1,647)

$         

19.26
28.49
18.90
21.80

536,124
249,575
16,607
(16,384)

$         

20.47
26.50
3.62
20.82

Outstanding balance at January 1, 2018
Granted
Lapsed
Forfeited (due to termination)
Quantity adjusted (due to performance

payout more than 100%), net of forfeited

-

-

(226,084)

22.43

Outstanding balance at December 31, 2018

205,873

$         

24.67

559,838

$         

21.86

The weighted average grant date fair value of restricted shares granted during the year 2018, 2017 
and 2016 were $28.49, $17.78, and $23.78, respectively. Total fair value of restricted stock vested 
during  the  year  ended  December  31,  2018,  2017  and  2016  was  $2,390,  $1,948  and  $2,335, 
respectively.   

At December 31, 2018, there was $8,824 of total unrecognized compensation cost related to non-
vested share-based compensation arrangements granted under the Plan. That cost is expected to 
be  recognized  over  a  weighted  average  period  of  0.96  years.  The  Company  currently  uses 
authorized and unissued Class B common shares to satisfy share award exercises. 

99 

 
  
 
 
 
             
             
Triple-S Management Corporation and Subsidiaries  
Notes to Consolidated Financial Statements 
December 31, 2018, 2017, and 2016 
(dollar amounts in thousands) 

22.  Net Income Available to Stockholders and Basic Net Income per Share 

The following table sets forth the computation of basic and diluted earnings per share for the three-
year period ended December 31: 

2018

2017

2016

Numerator for earnings per share

Net (loss) income attributable to TSM available to stockholders

$        

(63,302)

$         

54,486

$         

17,438

Denominator for basic earnings per share –
Weighted average of common shares

Effect of dilutive securities 

22,975,385

23,996,503

24,454,435

-

71,083

56,658

Denominator for diluted earnings per share

22,975,385

24,067,586

24,511,093

Basic net (loss) income per share attributable to TSM

$            

(2.76)

$             

2.27

$             

0.71

Diluted net (loss) income per share attributable to TSM

$            

(2.76)

$             

2.26

$             

0.71

The Company excluded the effect of dilutive securities during the year ended December 31, 2018 
because  their  effect  would  have  been  anti-dilutive  given  the  net  loss  attributable  to  stockholders 
during this year.  If the Company had generated income from continuing operations during the year 
ended December 31, 2018 the effect of the restricted stock awards on the diluted shares calculation 
would have been an increase in shares of 81,023 shares. 

23.  Commitments 

The  Company  leases  its  regional  offices,  certain  equipment,  and  warehouse  facilities  under  non-
cancelable  operating  leases.  Minimum  annual  rental  commitments  at  December 31,  2018  under 
existing agreements are summarized as follows:  

Year ending December 31

2019
2020
2021
2022
2023

Total

$        

5,214
2,972
1,713
1,220
224
11,343

$      

Rental expense for 2018, 2017, and 2016 was $8,924, $7,991, and $7,613 respectively. 

Pursuant to the provisions of the Puerto Rico Insurance Code and Regulations, TSP is a member of 
the Compulsory Vehicle Liability Insurance Joint Underwriting Association (JUA).  As a participant, 
TSP  shares  the  risk,  proportionately  with  other  members,  based  on  a  formula  established  by  the 
Puerto Rico Insurance Code, of the results and financial condition of the JUA, and accordingly, may 
be subject to assessments to cover obligations of the JUA or may receive refund distributions for 
good experience.  The Company received $215 in 2018 as an ordinary dividend.  No assessments 
were received in 2017.  During the  year ended December 31, 2017, the JUA declared a $70,000 
extraordinary dividend to its members, subject to a special tax rate of 50% as allowed by Act No. 26 
of April 29,  2017. There were no extraordinary dividends declared by the JUA in 2018  and 2016.  

100 

 
 
 
 
    
          
          
          
             
Triple-S Management Corporation and Subsidiaries  
Notes to Consolidated Financial Statements 
December 31, 2018, 2017, and 2016 
(dollar amounts in thousands) 

The  Company  receives  dividends  from  the  JUA  net  of  applicable  tax.    During  the  year  ended 
December 31, 2017, TSP recorded a special distribution of $2,363, net of tax, which is included as 
other income in the accompanying consolidated statements of earnings.   

24.  Contingencies 

The  Company’s  business  is  subject  to  numerous  laws  and  regulations  promulgated  by  Federal, 
Puerto Rico, USVI, Costa Rica, BVI, and Anguilla governmental authorities. Compliance with these 
laws and regulations can be subject to government review and interpretation, as well as regulatory 
actions unknown and unasserted at this time. The Commissioner of Insurance of Puerto Rico, as 
well  as  other  Federal,  Puerto  Rico,  USVI,  Costa  Rica,  BVI,  and  Anguilla  government  authorities, 
regularly make inquiries and conduct audits concerning the Company's compliance with such laws 
and  regulations.  Penalties  associated  with  violations  of  these  laws  and  regulations  may  include 
significant fines and exclusion from participating in certain publicly funded programs and may require 
the Company to comply with corrective action plans or changes in our practices. 

As of December 31, 2018, the Company is involved in various legal actions arising in the ordinary 
course  of  business.  The  Company  is  also  defendant  in  various  other  litigations  and  proceedings, 
some of which are described below.  Where the Company believes that a loss is both probable and 
estimable, such amounts have been recorded. Although the Company believes the estimates of such 
losses are reasonable, these estimates could change as a result of further developments in these 
matters. In other cases, it is at least reasonably possible that the Company may incur a loss related 
to one or more of the mentioned pending lawsuits or investigations, but the Company is unable to 
estimate  the  range  of  possible  loss  which  may  be  ultimately  realized,  either  individually  or  in  the 
aggregate,  upon  their  resolution.    The  outcome  of  legal  proceedings  is  inherently  uncertain  and 
pending matters for which accruals have not been established have not progressed sufficiently to 
enable us to estimate a range of possible loss, if any.  Given the inherent unpredictability of these 
matters, it is possible that an adverse outcome in one or more of these matters could have a material 
effect on the consolidated financial condition, operating results and/or cash flows of the Company. 

Additionally,  we  may  face  various  potential  litigation  claims  that  have  not  been  asserted  to  date, 
including  claims  from  persons  purporting  to  have  rights  to  acquire  shares  of  the  Company  on 
favorable  terms  pursuant  to  agreements  previously  entered  by  our  predecessor  managed  care 
subsidiary, Seguros de Servicios de Salud de Puerto Rico, Inc. (SSS), with physicians or dentists 
who joined our provider network to sell such new provider shares of SSS at a future date (Share 
Acquisition Agreements) or to have inherited such shares notwithstanding applicable transfer and 
ownership restrictions. 

Claims by Heirs of Former Shareholders 

The Company and TSS are defending six individual lawsuits: Vera Sanchez, et al, v. Triple-S; Olivella 
Zalduondo, et al, v. Seguros de Servicios de Salud, et al; Montilla Lopez, et al v. Seguros de Servicio 
de Salud, et al; Cebollero Santamaria v. Triple-S Salud, Inc., et al; Ruiz de Porras, et al, v. Triple-S 
Salud, Inc.; and Irizarry Antonmattei, et al, v. Seguros de Servicio de Salud, et al.  All claims were 
filed in the Puerto Rico Court of First Instance by persons who claim to have inherited a total of 83 
shares of the Company of one of its predecessors or affiliates (before giving effect to the 3,000-for-
one stock Split).  While each case presents unique facts and allegations, the lawsuits generally allege 
that the redemption of the shares by the Company pursuant to transfer and ownership restrictions 
contained in the Company’s (or its predecessors’ or affiliates’) articles of incorporation and bylaws 
was  improper.    Consequently,  the  remedy  requested  by  the  plaintiffs  to  be  recognized  as 
shareholders of the Company in the corresponding proportion. 

101 

 
Triple-S Management Corporation and Subsidiaries  
Notes to Consolidated Financial Statements 
December 31, 2018, 2017, and 2016 
(dollar amounts in thousands) 

As a result of the Puerto Rico Supreme Court’s decision to deny the applicability of the statute of 
limitations contained in the local securities law, these claims are being litigated on their merits. 

On January 11, 2019, local Court of Appeals confirmed Court of First Instance’s partial summary 
judgement in Wanda Irizarry Antonmattei, et al., v. Seguros de Servicios de Salud de Puerto Rico, 
Inc., et al. ordering the Company to issue 63,000 stock shares in favor of Plaintiffs. The Company 
filed an appeal before the Supreme Court on February 8, 2019.  

In Montilla López, et al. v. Seguros de Servicios de Salud, et al. local Court of First Instance entered 
summary judgment in favor of Company dismissing all claims on November 2, 2018. Plaintiffs filed 
an Appeal before Puerto Rico Court of Appeals which the Company opposed on January 18, 2019. 

Joint Underwriting Association Litigation 

On August  19,  2011,  plaintiffs, purportedly  a class of  motor vehicle owners, filed an  action in the 
United  States  District  Court  for  the  District  of  Puerto  Rico  against  the  JUA  and  TSP,  alleging 
violations  under  the  Puerto  Rico  Insurance  Code,  the  Puerto  Rico  Civil  Code,  the  Racketeer 
Influenced and Corrupt Organizations Act (RICO) and the local statute against organized crime and 
money laundering. JUA is a private association created by  law to administer a  compulsory public 
liability insurance program for motor vehicles in Puerto Rico (CLI). As required by its enabling act, 
JUA is composed of all the insurers that underwrite private motor vehicle insurance in Puerto Rico 
and exceed the minimum underwriting percentage established in such act. TSP is a member of JUA. 

In this lawsuit, entitled Noemí Torres Ronda, et al v. JUA et al., plaintiffs allege that the defendants 
illegally charged and misappropriated a portion of the CLI premiums paid by motor vehicle owners 
in violation of the Puerto Rico Insurance Code. Specifically, they claim that because the defendants 
did  not  incur  in  acquisition  or  administration  costs  allegedly  totaling  12%  of  the  premium  dollar, 
charging  for  such  costs  constitutes  the  illegal  traffic  of  premiums.  Plaintiffs  also  claim  that  the 
defendants, as members of JUA, violated RICO through various inappropriate actions designed to 
defraud motor vehicle owners located in Puerto Rico and embezzle a portion of the CLI premiums 
for their benefit.  

Plaintiffs seek the reimbursement of funds for the class amounting to $406,600 treble damages under 
RICO,  and  equitable  relief,  including  a  permanent  injunction  and  declaratory  judgment  barring 
defendants from their alleged conduct and practices, along with costs and attorneys’ fees. Discovery 
has been completed. 

Since 2011, TSP has been defending this claim and, jointly with other defendants, has filed several 
pleas in connection  with the certification of the class  and the  dismissal of the claim. On April  22, 
2016, plaintiff and the three negotiating defendants filed a stipulation of settlement and release which 
is  subject  to  approval  of  the  court.  TSP  and  the  non-settling  defendants  have  objected  the  filed 
settlement.  On  June  18,  2018,  defendants  moved  summary  judgment  on  grounds  of  res  judicata 
and/or collateral estoppel  arising from a parallel  dismissal with  prejudice confirmed by the  Puerto 
Rico Court of Appeals. 

102 

 
 
 
Triple-S Management Corporation and Subsidiaries  
Notes to Consolidated Financial Statements 
December 31, 2018, 2017, and 2016 
(dollar amounts in thousands) 

In re Blue Cross Blue Shield Antitrust Litigation 

TSS is a co-defendant with multiple Blue Plans and the Blue Cross Blue Shield Association (BCBSA) 
in a multi-district class action litigation filed by a group of providers and subscribers on July 24, 2012 
and October 1, 2012, respectively, that has since been consolidated by the United States District 
Court for the Northern District of Alabama, Southern Division, in the case captioned In re Blue Cross 
Blue Shield Association Antitrust Litigation. Essentially, provider plaintiffs allege that the exclusive 
service  area  requirements  of  the  Primary  License  Agreements  with  the  Blue  Plans  constitute  an 
illegal horizontal market allocation under federal antitrust laws. As per provider plaintiffs, the quid pro 
quo  for  said  “market  allocation”  is  a  horizontal  price  fixing  and  boycott  conspiracy”  implemented 
through  the  Inter-Plans  Program  Committee  (“IPPC”)  and  whose  benefits  are  allegedly  derived 
through the BCBSA’s Blue Card/National Accounts Program. Among the remedies sought, provider 
plaintiffs seek increased compensation rates and operational changes. In turn, subscriber plaintiffs 
allege that the alleged conspiracy to allocate markets have prevented subscribers from being offered 
competitive  prices  and  resulted  in  higher  premiums  for  Blue  Plan  subscribers.  Subscribers  seek 
damages in the form of supra-competitive premiums allegedly charged by the Blue Plans and/or the 
difference between what subscribers have paid the Blues and the lower competitive premiums that 
non-competing Blues would have charged. Both actions seek injunctive relief.  

Prior to consolidation, motions to dismiss were filed by several plans, including TSS - whose request 
was ultimately denied by the court without prejudice. On April 6, 2015, plaintiffs filed suit in the United 
States  District  Court  of  Puerto  Rico  against  TSS.  Said  complaint,  nonetheless,  is  believed  not  to 
preclude TSS’ jurisdictional arguments. Since inception, the Company has joined BCBSA and other 
Blue Plans in vigorously contesting these claims. On April 5, 2018, the United States District Court 
for the Northern District of Alabama, Southern Division, issued it’s ruling on the parties’ respective 
motions for partial summary judgment on the standard of review applicable to plaintiffs’ claims under 
Section 1 of the Sherman Act and subscriber plaintiffs’ motion for partial summary judgment on the 
Blue Plan’s single entity defense. After considering the “undisputed” facts (for summary judgment 
purposes only) and evidence currently on record in the light most favorable to defendants, the court 
essentially found that: (a) the Exclusive Service Areas constitute horizontal market allocations that 
are subject to the Per Se standard of review; (b) the National Best Efforts Rule constitutes an “output 
restriction” subject to the Per Se standard of review; (c) there remain genuine issues of material fact 
as to  whether defendants’  conduct can  be shielded  by  the “single entity” defense; and (d) claims 
concerning the BlueCard Program and uncoupling rules are due to be analyzed under the Rule of 
Reason standard.  

On April 16, 2018, Defendants moved the Federal District Court for the Northern District of Alabama 
to certify for immediate interlocutory appeal the court’s April 5, 2018 Standard of Review Ruling. On 
June  12,  2018,  judge  agreed  to  grant  Defendant’s  motion  for  certification  pursuant  to  28  U.S.C. 
§1292(b). Defendants filed their Notice of Appeal on July 12, 2018. On December 12, 2018, the Court 
of Appeals for the Eleventh Circuit denied Defendants’ petition to appeal the District Court’s Standard 
of Review Ruling. Given the Court of Appeal’s ruling, Defendants will continue to aggressively defend 
the case. On January 15, 2019, the parties appeared for a status conference to discuss the litigation’s 
schedule moving forward and next steps. 

103 

 
 
 
Triple-S Management Corporation and Subsidiaries  
Notes to Consolidated Financial Statements 
December 31, 2018, 2017, and 2016 
(dollar amounts in thousands) 

Claims Relating to the Provision of Health Care Services 

TSS  is  a  defendant  in  several  claims  for  collection  of  monies  in  connection  with  the  provision  of 
health care services.  

On  April  17,  2015,  ASES  notified  the  Company  of  a  complaint  from  a  medical  service  provider 
demanding payment amounting to $5,073.  Claimant alleges that TSS did not pay the claims, paid 
them incorrectly, or recovered payments from the provider for which TSS did not have the right. TSS 
answered  the  complaint  and  counterclaimed.    TSS  denies  any  wrongdoing  and  will  continue  to 
defend this matter vigorously. 

On  January  12,  2015,  American  Clinical  Solutions  LLC,  a  limited  liability  company  that  provides 
clinical laboratory services filed a complaint in Florida state court alleging that TSM and TSS failed 
to pay certain clinical laboratory services  provided to  Blue Cross Blue Shield members. TSS and 
TSM  have  filed  a  motion  to  dismiss  alleging  lack  of  jurisdiction.  TSM  and  TSS  also  requested  a 
transfer of the case to Puerto Rico. Plaintiff has requested jurisdictional discovery, which is ongoing. 
The claim amounts to $5,000. TSS and TSM will continue to vigorously oppose this claim. 

25.  Statutory Accounting 

TSS, TSA, TSV, TSP and TSB (collectively known as the regulated subsidiaries) are regulated by 
the  Commissioner  of  Insurance.  The  regulated  subsidiaries  are  required  to  prepare  financial 
statements using accounting practices prescribed or permitted by the Commissioner of Insurance, 
which uses a comprehensive basis of accounting other than GAAP. Specifically, the Commissioner 
of Insurance has adopted the NAIC’s Statutory Accounting Principles (NAIC SAP) as the basis of its 
statutory accounting practices, as long as they do not contravene the provisions of the Puerto Rico 
Insurance Code, its regulations and the Circular Letters issued by the Commissioner of Insurance. 
The Commissioner of Insurance may permit other specific practices that may deviate from prescribed 
practices  and  NAIC  SAP.  Statutory  accounting  principles  that  are  established  by  state  laws  and 
permitted  practices  mandated  by  the  Commissioner  of  Insurance may  cause  the  statutory  capital 
and surplus of the regulated subsidiaries to differ from that calculated under the NAIC SAP. 

Prescribed  statutory  accounting  practices  in  Puerto  Rico  allow  TSP  to  disregard  a  deferred  tax 
liability resulting from additions to the catastrophe loss reserve trust fund that would otherwise be 
required  under  NAIC  SAP.  The  use  of  prescribed  and  permitted  accounting  practices,  both 
individually  and  in  the  aggregate,  did  not  change  significantly  the  combined  statutory  capital  and 
surplus that would have been reported following NAIC SAP, which as of December 31, 2018 and 
2017  is  approximately  2.1%  and  1.0%,  respectively,  lower  than  the  combined  reported  statutory 
capital and surplus.  

The regulated subsidiaries are required by the NAIC and the Commissioner of Insurance to submit 
risk-based capital (RBC) reports following the NAIC’s RBC Model Act and accordingly, are subject 
to certain regulatory actions if their capital levels do not meet minimum specific RBC requirements.  
RBC  is  a  method  developed  by  the  NAIC  to  determine  the  minimum  amount  of  statutory  capital 
appropriate for an insurance company to support its overall business operations in consideration of 
its  size  and  risk  profile.  The  RBC  is  calculated  by  applying  capital  requirement  factors  to  various 
assets, premiums and reserve items. The factor is higher for those items with greater underlying risk 
and lower for less risky items. The adequacy of an organization’s actual capital can then be measured 
by a comparison to its RBC as determined by the formula. 

104 

 
Triple-S Management Corporation and Subsidiaries  
Notes to Consolidated Financial Statements 
December 31, 2018, 2017, and 2016 
(dollar amounts in thousands) 

The  RBC  Model  Act  requires  increasing  degrees  of  regulatory  oversight  and  intervention  as  an 
organization’s  risk-based  capital  declines.  The  level  of  regulatory  oversight  ranges  from  requiring 
organizations  to  inform  and  obtain  approval  from  the  domiciliary  insurance  commissioner  of  a 
comprehensive financial plan for increasing its RBC, to mandatory regulatory intervention requiring 
an  insurance  company  to  be  placed  under  regulatory  control,  in  a  rehabilitation  or  liquidation 
proceeding. 

The  Commissioner  of  Insurance  adopted  in  2009  an  RBC  policy  that  requires  that  the  regulated 
entities  maintain  statutory  reserves  at  or  above  the  “Company  Action  Level,”  in  order  to  avoid 
regulatory monitoring and intervention.  The Company action level is currently set at 200% of the 
RBC for TSA, since it is organized as a health service organization and 300% of the RBC for TSS, 
TSV, and TSB. The RBC requirement for TSP is 300% but compliance with certain trend analysis 
can lower this requirement to 200%.  As of December 31, 2018, all regulated subsidiaries comply 
with  minimum  statutory  reserve  requirements,  except  for  TSP  which  is  currently  in  an  RBC 
remediation  plan  with  the  Commissioner  of  Insurance.  As  of  December  31,  2017,  all  regulated 
subsidiaries complied with minimum statutory reserve requirements. 

The  following  table  sets  forth  the  combined  net  admitted  assets,  capital  and  surplus,  RBC 
requirement, which is our statutory capital and surplus requirement, and net income for the regulated 
subsidiaries at December 31, 2018, 2017 and 2016: 

(dollar amounts in millions)

2018

2017

2016

Net admitted assets

Capital and surplus

RBC requirement

Net (loss) income

$           

2,089

$           

2,102

$           

1,829

602
312
(32)

647
301
87

638
278
24

As more fully described in note 17, a portion of the accumulated earnings and admitted assets of 
TSP are restricted by  the  catastrophe loss reserve  and the trust fund balance  as required  by  the 
Insurance Code.  The total catastrophe loss reserve and trust fund amounted to $37,749 and $38,978 
as of December 31, 2018, respectively. The total catastrophe loss reserve and trust fund amounted 
to $27,843 and $48,363 as of December 31, 2017, respectively.  In addition, the admitted assets of 
the  regulated  subsidiaries  are  restricted  by  the  investments  deposited  with  the  Commissioner  of 
Insurance to comply  with requirements of the Insurance Code (see note  3).  Investments with  an 
amortized cost of $1,567 and $5,229 (fair value of $1,602 and $5,571) at December 31, 2018 and 
2017, respectively, were deposited with the Commissioner of Insurance. As a result, the combined 
restricted assets for our regulated subsidiaries were $40,545 and $53,592 as of December 31, 2018 
and 2017, respectively. 

105 

 
   
 
               
               
               
               
               
               
                
                 
                 
Triple-S Management Corporation and Subsidiaries  
Notes to Consolidated Financial Statements 
December 31, 2018, 2017, and 2016 
(dollar amounts in thousands) 

26.  Supplementary Information on Cash Flow Activities 

2018

2017

2016

Supplementary information
Noncash transactions affecting cash

flow activities

Change in net unrealized (gain) loss on

securities available for sale,
including deferred income tax
liability (asset) of ($1,870), $3,846, and 
 $1,085 in 2018, 2017, and 2016,
respectively

Change in liability for pension

benefits, and deferred income
tax (asset) liability of $457, ($3,202),
$10,792, in 2018, 2017, and 2016,
respectively

$           

9,048

$        

(13,867)

$              

107

$             

(738)

$           

5,008

$        

(16,879)

Repurchase and retirement of common stock

$             

(748)

$              

(89)

$              

(56)

Exercise of stock options

$                  
-

$                  
-

$               

55

Other

Income taxes paid
Interest paid

27.  Segment Information 

$           
$           

8,978
6,903

$         
$           

10,363
6,794

$         
$           

11,549
7,635

The  operations  of  the  Company  are  conducted  principally  through  three  reportable  business 
segments:  Managed  Care,  Life  Insurance,  and  Property  and  Casualty  Insurance.    Reportable 
business segments were identified according to the type of insurance products offered and consistent 
with  the  information  provided  to  the  chief  operating  decision  maker.  These  segments  and  a 
description of their respective operations are as follows: 

•  Managed Care segment – This segment is engaged in the sale of managed care products to 
the  Commercial,  Medicare  and  Medicaid  market  sectors.    The  Commercial  accounts  sector 
includes  corporate  accounts,  U.S.  federal  government  employees,  individual  accounts,  local 
government employees, and Medicare supplement. The following represents a description of the 
major contracts by sector: 

– 

– 

– 

The  segment  is  a  qualified  contractor  to  provide  health  coverage  to  federal  government 
employees  within  Puerto  Rico  and  the  USVI.  Earned  premiums  revenue  related  to  this 
contract amounted to $150,232, $156,417 and $163,556 for the years ended December 31, 
2018, 2017, and 2016, respectively (see note 12).  

Under  its  commercial  business,  the  segment  also  provides  health  coverage  to  certain 
employees of the Commonwealth of Puerto Rico and its instrumentalities. Earned premium 
revenue related to such health plans amounted to $24,186, $28,149 and $29,475 for years 
ended December 31, 2018, 2017, and 2016, respectively.  

The  segment  provides  services  through  its  Medicare  health  plans  pursuant  to  a  limited 
number of contracts with CMS. Earned premium revenue related to the Medicare business 

106 

 
 
 
Triple-S Management Corporation and Subsidiaries  
Notes to Consolidated Financial Statements 
December 31, 2018, 2017, and 2016 
(dollar amounts in thousands) 

amounted to $1,130,226, $1,035,285, and $1,023,904 for the years ended December 31, 
2018, 2017, and 2016, respectively. 

– 

The  segment  also  participates  in  the  Medicaid  program  to  provide  health  coverage  to 
medically  indigent  citizens  in  Puerto  Rico,  as  defined  by  the  laws  of  the  government  of 
Puerto  Rico.    Earned  premium  revenue  related  to  this  business  amounted  to  $776,038, 
$751,393,  and  $783,231  for  the  years  ended  December  31,  2018,  2017,  and  2016, 
respectively.  

•  Life Insurance segment – This segment offers primarily life and accident and health insurance 
coverage, and annuity products. The premiums for this segment are mainly subscribed through 
an internal sales force and a network of independent brokers and agents. 

•  Property  and  Casualty  Insurance  segment  –The  predominant  insurance  products  of  this 
segment commercial package, commercial auto, and personal package. The premiums for this 
segment are originated through a network of independent insurance agents and brokers. Agents 
or general agencies collect the premiums from the insureds, which are subsequently remitted to 
the segment, net of commissions. Remittances are generally due 60 days after the closing date 
of the general agent’s account current. 

The Company 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 less operating costs. 

The accounting policies for the segments are the same as those described in the summary of significant 
accounting policies included in the notes to consolidated financial statements.  The financial data of each 
segment  is  accounted  for  separately;  therefore,  no  segment  allocation  is  necessary.  However,  certain 
operating expenses are centrally managed, therefore requiring an allocation to each segment. Most of these 
expenses are distributed to each segment based on different parameters, such as payroll hours, processed 
claims, or square footage, among others. In addition, some depreciable assets are kept by one segment, 
while allocating the depreciation expense to other segments. The allocation of the depreciation expense is 
based  on  the  proportion  of  assets  used  by  each  segment.  Certain  expenses  are  not  allocated  to  the 
segments and are kept within TSM’s operations. 

107 

 
 
 
Triple-S Management Corporation and Subsidiaries  
Notes to Consolidated Financial Statements 
December 31, 2018, 2017, and 2016 
(dollar amounts in thousands) 

The following tables summarize the operations by operating segment for each of the years in the three-year 
period ended December 31: 

2018

2017

2016

Operating revenues
Managed care

Premiums earned, net
Fee revenue
Intersegment premiums/fee revenue
Net investment income

$       

2,687,773
14,701
5,690
23,827

$       

2,588,692
16,514
6,362
16,659

$       

2,647,169
17,843
5,918
15,102

Total managed care

2,731,991

2,628,227

2,686,032

Life

Premiums earned, net
Intersegment premiums
Net investment income

Total life

Property and casualty

Premiums earned, net
Intersegment premiums
Net investment income

Total property and casualty

Other segments*

Intersegment service revenues
Operating revenues from external sources

Total other segments

Total business segments

TSM operating revenues from external sources
Elimination of intersegment premiums
Elimination of intersegment service revenue
Other intersegment eliminations

167,888
668
25,658

194,214

82,930
613
10,800

94,343

283
5,794

6,077

161,628
218
24,819

186,665

76,612
613
9,489

86,714

8,677
3,763

12,440

156,140
716
24,877

181,733

87,332
613
8,891

96,836

9,907
3,563

13,470

3,026,625

2,914,046

2,978,071

1,624
(6,971)
(283)
-

545
(7,193)
(8,677)
-

19
(7,247)
(9,907)
(78)

Consolidated operating revenues

$       

3,020,995

$       

2,898,721

$       

2,960,858

* Includes segments that are not required to be reported separately, primarily the data processing services

organization and the health clinics.

108 

 
 
Triple-S Management Corporation and Subsidiaries  
Notes to Consolidated Financial Statements 
December 31, 2018, 2017, and 2016 
(dollar amounts in thousands) 

Operating income (loss)
Managed care
Life
Property and casualty
Other segments*

Total business segments

TSM operating revenues from external sources
TSM unallocated operating expenses
Elimination of TSM charges

Consolidated operating (loss) income

Consolidated net realized investment gains 
Consolidated net unrealized investment losses on

equity securities

Consolidated interest expense
Consolidated other income, net

2018

2017

2016

$      

26,468
19,901
(110,119)
8

$       

55,040
19,434
(6,034)
(391)

$      

(36,777)
21,458
12,074
(1,784)

(63,742)
1,624
(8,815)
9,600

(61,333)
298

(36,546)
(6,903)
11,312

68,049
545
(9,787)
9,600

68,407
10,831

-
(6,794)
6,533

(5,029)
19
(9,739)
9,522

(5,227)
17,379

-
(7,635)
6,569

Consolidated (loss) income before taxes

$      

(93,172)

$       

78,977

$       

11,086

Depreciation and amortization expense
Managed care
Life
Property and casualty
Other segments*

Total business segments

TSM depreciation expense

2018

2017

2016

$      

10,525
1,134
384
705

12,748

787

$       

10,007
1,203
528
673

$       

11,114
1,030
544
645

12,411

787

13,333

787

Consolidated depreciation and amortization expense

$       

13,535

$       

13,198

$       

14,120

* Includes segments that are not required to be reported separately, primarily the data processing services

organization and the health clinics.

109 

 
 
 
  
        
     
                
          
             
             
Triple-S Management Corporation and Subsidiaries  
Notes to Consolidated Financial Statements 
December 31, 2018, 2017, and 2016 
(dollar amounts in thousands) 

Assets
Managed care
Life
Property and casualty
Other segments*

Total business segments

Unallocated amounts related to TSM

Cash, cash equivalents, and investments
Property and equipment, net
Other assets

Elimination entries – intersegment receivables and others

2018

2017

2016

$    

1,078,262
863,470
747,583
20,705

$     

1,092,715
853,289
1,094,773
19,027

$  

1,013,872
816,920
349,159
26,034

2,710,020

3,059,804

2,205,985

57,818
21,733
22,521

102,072

(51,844)

81,169
22,257
22,763

126,189

17,033
22,380
21,646

61,059

(69,228)

(48,045)

Consolidated total assets

$     

2,760,248

$     

3,116,765

$  

2,218,999

Significant noncash items
Net change in unrealized gain (loss) on securities available for sale

Managed care
Life
Property and casualty
Other segments*

Total business segments

Amount related to TSM

2018

2017

2016

$          

2,585
(11,285)
(583)
-

(9,283)

235

$           

3,932
7,142
2,691
-

13,765

102

$           

104
2,659
(2,984)
105

(116)

9

Consolidated net change in unrealized (loss) gain

on securities available for sale

$          

(9,048)

$         

13,867

$          

(107)

* Includes segments that are not required to be reported separately, primarily the data processing services 

organization and the health clinics.

28.  Subsequent Events 

The Company evaluated subsequent events through the date the consolidated financial statements 
were  issued.    No  events,  other  than  those  described  in  these  notes,  have  occurred  that  require 
adjustment or disclosure pursuant to current Accounting Standard Codification.   

110 

 
   
 
 
 
 
        
        
          
          
          
          
         
             
               
annual
report‘18