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8-K - FORM 8-K - TRIPLE-S MANAGEMENT CORPd348568d8k.htm

Exhibit 99.1

 

LOGO

Triple-S Management Corporation

1441 F.D. Roosevelt Ave.

San Juan, PR 00920

www.triplesmanagement.com

FOR FURTHER INFORMATION:

 

AT THE COMPANY:    INVESTOR RELATIONS:   
Alan Cohen    Kathy Waller   
Chief Marketing & Communications Officer    AllWays Communicate, LLC   
(787) 706-2570    (312) 543-6708   

Triple-S Management Corporation Reports First Quarter 2012 Results

SAN JUAN, Puerto Rico, May 2, 2012 – Triple-S Management Corporation (NYSE:GTS), one of the leading managed care companies in Puerto Rico, today announced consolidated revenues of $589.8 million and operating income of $8.9 million for the three months ended March 31, 2012. Net income was $7.5 million, or $0.26 per diluted share.

First-Quarter Consolidated Highlights

 

   

Total consolidated operating revenues were $587.0 million;

 

   

Operating income was $8.9 million;

 

   

Consolidated loss ratio was 86.9%;

 

   

Medical loss ratio (MLR) was 90.5%;

 

   

Managed Care member month enrollment increased 107.1%;

 

   

Medicare member month enrollment increased 30.1%.

Ramón M. Ruiz-Comas, President and Chief Executive Officer of Triple-S Management Corporation, commented on the period’s results, “Although revenues and membership exceeded our internal forecast and the Commercial MLR, Medicaid ASO contract, and operating expenses met our expectations, we experienced disappointing results in our American Health business.”

Mr. Ruiz-Comas continued, “Specifically, our Medicare Advantage medical loss ratio was adversely impacted by lower-than-expected premiums and increased utilization, mostly in pharmacy, at American Health. Additionally, our Property and Casualty Insurance segment incurred unusually high claims, resulting from several large auto liability incidents.”

“Although the first quarter is our seasonally weakest, the negative impact of American Health’s performance in the quarter and our current expectation of continuing weakness in that division have resulted in our decision to lower our 2012 guidance. We plan to re-negotiate contracts with American Health’s PBM and other providers. In addition, we have created a cross divisional task force within our Managed Care segment to re-evaluate and analyze our product designs at American Health for the 2013 bidding process. We are optimistic that our other businesses will remain on track. Furthermore, we will continue to pursue a variety of initiatives aimed at managing both medical and operating costs,” concluded Mr. Ruiz-Comas.

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Selected Quarterly Details

 

   

Pro Forma Net Income was $6.1 million, or $0.21 Per Diluted Share. Weighted average shares outstanding were 28.5 million. This compares with pro forma net income of $12.9 million, or $0.44 per diluted share, in the corresponding quarter of 2011, based on weighted average shares outstanding of 29.0 million.

 

   

Consolidated Premiums Increased 12.8%, to $547.3 Million. The increase was principally due to the higher member month enrollment in the Medicare and Commercial businesses in our Managed Care segment.

 

   

Consolidated Administrative Service Fees Rose 316.7%, to $27.5 Million. The significant increase in service fees was driven by the addition of the miSalud business, effective November 1, 2011.

 

   

Managed Care Membership. Our Managed Care membership grew by 106.9% year over year, reflecting the addition of the miSalud business, in which self-insured membership was 876,230 at the end of the quarter. Medicare membership increased 15.6%, to 120,007. Fully insured Commercial membership was 488,632, down 2.1% from the same period last year.

 

   

Managed Care MLR Increased 320 Basis Points, to 90.5%. The increased MLR results from higher-than-expected utilization and cost trends in the Medicare business, primarily at American Health.

 

   

Consolidated Loss Ratio Increased 390 Basis Points, to 86.9%. The higher consolidated loss ratio mainly results from the 320-basis-point increase in the Managed Care MLR. The loss ratio of the Property and Casualty and Life Insurance segments also experienced year-over-year increases.

 

   

Consolidated Operating Expense Ratio Rose 100 Basis Points, to 17.8%. The higher consolidated operating expense ratio reflects the increased self-insured contracts associated with our participation in the miSalud business.

 

   

Consolidated Operating Income Decreased 51.6%, to $8.9 Million. The decline mostly reflects the increased MLR in the Medicare business and unusually high claims resulting from several auto liability incidents in the Property and Casualty Insurance segment.

 

   

Consolidated Operating Income Margin Was 1.5%. The consolidated operating margin declined by 220 basis points year-over-year, primarily due to lower profitability in our Managed Care and Property and Casualty Insurance segments.

 

   

Consolidated Effective Tax Rate Was 17.6%. The consolidated income tax expense decreased by $8.0 million, or 83.3%, mostly because the 2011 tax expense included a one-time, $6.4 million charge, resulting from a reduction of the net deferred tax assets following the enactment of the new Puerto Rico tax reform. Effective January 2011, this legislation reduced the maximum corporate income tax rate from 39% to approximately 30%. Also contributing to the lower effective tax rate in the first quarter of 2012 is a reduction in the Managed Care segment’s taxable income, which operates at a higher effective rate.

 

   

Parent Company Information. As of March 31, 2012, Triple-S Management had $48.5 million in parent company cash, cash equivalents, and investments.

 

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     Pro Forma Net
Income
 
(Unaudited)    Three months
ended March 31,
 

(dollar amounts in millions)

   2012      2011  

Net income

   $ 7.5       $ 10.4   

Less pro forma adjustments:

     

Net realized investment gains, net of tax

     1.4         5.0   

Net unrealized trading investments, net of tax

     —           (1.0

Derivative loss, net of tax

     —           (0.1

Charge related to change in enacted tax rate

     —           (6.4
  

 

 

    

 

 

 

Pro forma net income

   $ 6.1       $ 12.9   
  

 

 

    

 

 

 

Diluted pro forma net income per share

   $ 0.21       $ 0.44   
  

 

 

    

 

 

 

Segment Performance

Triple-S Management operates in three segments: 1) Managed Care, 2) Life Insurance, and 3) Property and Casualty Insurance. Management evaluates performance based primarily on the operating revenues and operating income of each segment. Operating revenues include premiums earned, net administrative service fees and net investment income. Operating costs include claims incurred and operating expenses. The Company calculates operating income or loss as operating revenues minus operating expenses. Operating margin is defined as operating income or loss divided by operating revenues.

 

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(Unaudited)    Three months ended March 31,  

(dollar amounts in millions)

   2012     2011     Percentage
Change
 

Premiums earned, net:

      

Managed Care:

      

Commercial

   $ 241.6      $ 236.4        2.2

Medicare

     254.2        194.1        31.0

Medicaid

     —          2.8        (100.0 %) 
  

 

 

   

 

 

   

 

 

 

Total Managed Care

     495.8        433.3        14.4

Life Insurance

     30.0        27.0        11.1

Property and Casualty

     22.2        25.7        (13.6 %) 

Other

     (0.7     (0.7     0.0
  

 

 

   

 

 

   

 

 

 

Consolidated premiums earned, net

   $ 547.3      $ 485.3        12.8
  

 

 

   

 

 

   

 

 

 

Operating revenues:

      

Managed Care

   $ 528.4      $ 445.1        18.7

Life Insurance

     34.9        31.4        11.1

Property and Casualty

     24.4        27.9        (12.5 %) 

Other

     (0.7     (0.7     0.0
  

 

 

   

 

 

   

 

 

 

Consolidated operating revenues

   $ 587.0      $ 503.7        16.5
  

 

 

   

 

 

   

 

 

 

Operating income:

      

Managed Care

   $ 7.4      $ 12.4        (40.3 %) 

Life Insurance

     4.4        4.2        4.8

Property and Casualty

     (1.4     1.0        (240.0 %) 

Other

     (1.5     0.8        (287.5 %) 
  

 

 

   

 

 

   

 

 

 

Consolidated operating income

   $ 8.9      $ 18.4        (51.6 %) 
  

 

 

   

 

 

   

 

 

 

Operating margin:

      

Managed Care

     1.4     2.8     -140 bp 

Life Insurance

     12.6     13.4     -80 bp 

Property and Casualty

     (5.7 %)      3.6     -930 bp 

Consolidated

     1.5     3.7     -220 bp 
  

 

 

   

 

 

   

 

 

 

Depreciation and amortization expense

   $ 5.9      $ 5.2        13.5
  

 

 

   

 

 

   

 

 

 

 

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Managed Care Additional Data

 

      Three months ended
March 31,
 

(Unaudited)

   2012     2011  

Member months enrollment:

    

Commercial:

    

Fully-insured

     1,467,148        1,463,381   

Self-insured

     659,500        724,159   
  

 

 

   

 

 

 

Total Commercial

     2,126,648        2,187,540   

Medicare:

    

Medicare Advantage

     329,944        246,468   

Stand-alone PDP

     25,271        26,567   
  

 

 

   

 

 

 

Total Medicare

     355,215        273,035   

Medicaid:

    

Fully-insured

     —          —     

Self-insured

     2,612,958        —     
  

 

 

   

 

 

 

Total Medicaid

     2,612,958        —     
  

 

 

   

 

 

 

Total member months

     5,094,821        2,460,575   
  

 

 

   

 

 

 

Claim liabilities (in millions)

   $ 275.2      $ 262.2   

Days claim payable

     55.8        58.2   
  

 

 

   

 

 

 

Premium PMPM:

    

Managed Care

   $ 272.08      $ 249.53   

Commercial

     164.90        161.56   

Medicare

     715.66        710.97   

Medical loss ratio

     90.5     87.3

Commercial

     89.5     90.6

Medicare Advantage

     91.0     86.8

Stand-alone PDP

     92.5     86.8

Adjusted medical loss ratio

     89.8     87.3

Commercial

     87.1     86.5

Medicare Advantage

     92.5     88.3

Stand-alone PDP

     90.3     89.9
  

 

 

   

 

 

 

Operating expense ratio:

    

Consolidated

     17.8     16.8

Managed Care

     13.8     12.3

 

* Information provided as of December 31, 2011.

 

 

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Managed Care Membership by Segment

     As of March 31,  
     2012      2011  

Members:

     

Commercial:

     

Fully-insured

     488,632         498,909   

Self-insured

     219,136         221,073   

Total Commercial

     707,768         719,982   

Medicare:

     

Medicare Advantage

     111,531         94,884   

Stand-alone PDP

     8,476         8,910   
  

 

 

    

 

 

 

Total Medicare

     120,007         103,794   

Medicaid – Self-insured

     876,230         —     
  

 

 

    

 

 

 

Total members

     1,704,005         823,776   
  

 

 

    

 

 

 

2012 Guidance

Mr. Ruiz-Comas stated, “Due to the lackluster performance in the quarter and challenges we face with American Health, including our revised projections for this subsidiary for the remainder of the year, we are changing our full-year guidance. We are increasing our MLR and Consolidated Loss Ratio to 88.8% – 89.8% and 85.0% - 86.0%, respectively, and reducing our earnings per share to $1.80 to $1.85.”

 

     2012 Range

Medical enrollment fully-insured (member months)

   7.2 - 7.4 million

Medical enrollment self-insured (member months)

   12.7 - 13.0 million

Consolidated operating revenues (in billions)

   $2.3 - $2.4

Consolidated loss ratio

   85.0% - 86.0%

Medical loss ratio

   88.8% - 89.8%

Consolidated operating expense ratio

   17.2% - 18.2%

Consolidated operating income (in millions)

   $67.0 - $77.0

Consolidated effective tax rate

   25% - 26%

Pro forma earnings per share

   $1.80 - $1.85

Weighted average of diluted shares outstanding (in millions)

   28.5

 

 

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Conference Call and Webcast

Management will host a conference call and webcast on May 2, 2012 at 10:00 a.m., Eastern Time to discuss its financial results for the three months ended March 31, 2012. To participate, callers within the U.S. and Canada should dial 1-877-941-0844, and international callers should dial 1-480-629-9835 about five minutes before the presentation.

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

About Triple-S Management Corporation

Triple-S Management Corporation is an independent licensee of the Blue Cross Blue Shield Association. It is the leading player in the managed care industry in Puerto Rico. Triple-S Management also has the exclusive right to use the Blue Cross Blue Shield name and mark throughout Puerto Rico and the U.S. Virgin Islands. With more than 50 years of experience in the industry, Triple-S Management offers a broad portfolio of managed care and related products in the Commercial and Medicare Advantage markets under the Blue Cross Blue Shield brand through its subsidiary Triple-S Salud, Inc. and effective February 2011, also offers non-branded Medicare products through American Health Inc. In addition to its managed care business, Triple-S Management provides non-Blue Cross Blue Shield branded life and property and casualty insurance in Puerto Rico.

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

Forward-Looking Statements

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

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

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

 

   

Trends in health care costs and utilization rates

 

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Ability to secure sufficient premium rate increases

 

   

Competitor pricing below market trends of increasing costs

 

   

Re-estimates of policy and contract liabilities

 

   

Changes in government laws and regulations of managed care, life insurance or property and casualty insurance

 

   

Significant acquisitions or divestitures by major competitors

 

   

Introduction and use of new prescription drugs and technologies

 

   

A downgrade in the Company’s financial strength ratings

 

   

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

 

   

Ability to contract with providers consistent with past practice

 

   

Ability to successfully implement the Company’s disease management, utilization management and Star ratings programs

 

   

Volatility in the securities markets and investment losses and defaults

 

   

General economic downturns, major disasters, and epidemics

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

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

-FINANCIAL TABLES ATTACHED-

 

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Condensed Consolidated Balance Sheets

(Dollar amounts in thousands, except per share data)

 

     Unaudited
March 31,
2012
     December 31,
2011
 
Assets      

Investments

   $ 1,194,531       $ 1,153,293   

Cash and cash equivalents

     135,561         71,834   

Premium and other receivables, net

     307,463         287,184   

Deferred policy acquisition costs and value of business acquired

     158,166         155,788   

Property and equipment, net

     97,924         81,872   

Other assets

     135,937         130,606   
  

 

 

    

 

 

 

Total assets

   $ 2,029,582       $ 1,880,577   
  

 

 

    

 

 

 
Liabilities and Stockholders’ Equity      

Policy liabilities and accruals

   $ 928,741       $ 836,029   

Accounts payable and accrued liabilities

     272,432         253,202   

Long-term borrowings

     127,736         114,387   
  

 

 

    

 

 

 

Total liabilities

     1,328,909         1,203,618   
  

 

 

    

 

 

 

Stockholders’ equity:

     

Common stock

     28,433         28,365   

Other stockholders equity

     671,882         648,594   
  

 

 

    

 

 

 

Total Triple-S Management Corporation stockholders’ equity

     700,315         676,959   
  

 

 

    

 

 

 

Noncontrolling interest in consolidated subsididary

     358         —     
  

 

 

    

 

 

 

Total stockholders’ equity

     700,673         676,959   
  

 

 

    

 

 

 

Total liabilities and stockholders’ equity

   $ 2,029,582       $ 1,880,577   
  

 

 

    

 

 

 

 

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Condensed Consolidated Statements of Earnings

(Dollar amounts in thousands, except per share data)

 

    

For the Three Months Ended

March 31,

 
     Unaudited
2012
     Historical
2011
 

Revenues:

     

Premiums earned, net

   $ 547,304       $ 485,271   

Administrative service fees

     27,524         6,595   

Net investment income

     11,192         11,798   

Other operating revenues

     1,047         —     
  

 

 

    

 

 

 

Total operating revenues

     587,067         503,664   
  

 

 

    

 

 

 

Net realized investment gains

     1,678         5,893   

Net unrealized investment loss on trading securities

     —           (1,141

Other income (expense), net

     1,070         14   
  

 

 

    

 

 

 

Total revenues

     589,815         508,430   
  

 

 

    

 

 

 

Benefits and expenses:

     

Claims incurred

     475,644         402,573   

Operating expenses

     102,506         82,711   
  

 

 

    

 

 

 

Total operating costs

     578,150         485,284   

Interest expense

     2,558         3,127   
  

 

 

    

 

 

 

Total benefits and expenses

     580,708         488,411   
  

 

 

    

 

 

 

Income before taxes

     9,107         20,019   
  

 

 

    

 

 

 

Income tax expense

     1,607         9,649   
  

 

 

    

 

 

 

Net income

   $ 7,500       $ 10,370   

Less: Net loss attributable to the noncontrolling interest

     14         —     
  

 

 

    

 

 

 

Net income attributable to Triple-S Management Corporation

   $ 7,514       $ 10,370   
  

 

 

    

 

 

 

Basic net income per share

   $ 0.27       $ 0.36   

Diluted earnings per share

   $ 0.26       $ 0.36   

 

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Condensed Consolidated Statements of Cash Flows

(Dollar amounts in thousands, except per share data)

 

    

For the Three Months Ended

March 31,

 
     Unaudited
2012
    Historical
2011
 

Net cash provided by operating activities

   $ 74,161      $ 101,387   
  

 

 

   

 

 

 

Cash flows from investing activities:

    

Proceeds from investments sold or matured:

    

Securities available for sale:

    

Fixed maturities sold

     29,843        14,986   

Fixed maturities matured/called

     35,482        33,964   

Equity securities

     22,649        9,458   

Securities held to maturity:

    

Fixed maturities matured/called

     300        181   

Acquisition of investments:

    

Securities available for sale:

    

Fixed maturities

     (62,487     (32,224

Equity securities

     (40,652     (29,134

Securities held to maturity:

    

Fixed maturities

     (300     —     

Net inflows / (outflows) for policy loans

     69        (11

Acquisition of business, net of cash acquired of $816 and $29,370 in the three months ended March 31, 2012 and 2011, respectively

     (2,685     (54,058

Net capital expenditures

     (2,783     (3,977
  

 

 

   

 

 

 

Net cash used in investing activities

     (20,564     (60,815
  

 

 

   

 

 

 

Cash flows from financing activities:

    

Change in outstanding checks in excess of bank balances

     5,539        3,454   

Payments of short-term borrowings, net

     —          (15,575

Repayments of long-term borrowings

     (490     (410

Repurchase and retirement of common stock

     —          (1,557

Proceeds from policyholder deposits

     6,492        1,824   

Cash settlements of stock options

     —          (1,259

Proceeds from exercise of stock options

     316        94   

Surrenders of policyholder deposits

     (1,727     (1,776
  

 

 

   

 

 

 

Net cash used in financing activities

     10,130        (15,205
  

 

 

   

 

 

 

Net increase in cash and cash equivalents

     63,727        25,367   

Cash and cash equivalents, beginning of period

     71,834        45,021   
  

 

 

   

 

 

 

Cash and cash equivalents, end of period

   $ 135,561      $ 70,388   
  

 

 

   

 

 

 

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