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United States Securities and Exchange Commission
Washington, D.C. 20549
FORM 10-Q
(Mark One)
     
þ   QUARTERLY REPORT PURSUANT TO SECTION 13 OR 15(D) OF THE SECURITIES EXCHANGE ACT OF 1934
For the quarterly period ended March 31, 2006
OR
     
o   TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(D) OF THE SECURITIES EXCHANGE ACT OF 1934
For the transition period from                      to                     
COMMISSION FILE NUMBER: 0-49762
Triple-S Management Corporation
(Exact name of registrant as specified in its charter)
     
Puerto Rico   66-0555678
(State or other jurisdiction of incorporation or   (I.R.S. Employer Identification No.)
organization)    
     
1441 F.D. Roosevelt Avenue    
San Juan, Puerto Rico   00920
(Address of principal executive offices)   (Zip code)
(787) 749-4949
(Registrant’s telephone number, including area code)
Not applicable
(Former name, former address and former fiscal year, if changed since last report)
Indicate by check mark whether the registrant (1) has filed all reports required to be filed by Section 13 or 15(d) of the Securities Exchange Act of 1934 during the preceding 12 months (or for such shorter period that the registrant was required to file such reports), and (2) has been subject to such filing requirements for the past 90 days. þ Yes o No
Indicate by check mark whether the registrant is a large accelerated filer, an accelerated filer, or a non-accelerated filer. See definition of “accelerated filer and large accelerated filer” in Rule 12b-2 of the Exchange Act. (Check one):
         
Large accelerated filer o   Accelerated filer o   Non-accelerated filer þ
Indicate by check mark whether the registrant is a shell company (as defined in Rule 12b-2 of the Exchange Act). o Yes þ No
Indicate the number of shares outstanding of each of the issuer’s classes of common stock, as of the latest practicable date.
     
Title of each class   Outstanding at March 31, 2006
     
Common Stock, $40.00 par value   8,911
 
 

 


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Triple-S Management Corporation
FORM 10-Q
For the Quarter Ended March 31, 2006
Table of Contents
         
        PAGE
PART I – FINANCIAL INFORMATION    
   
 
   
     
      3
      4
      5
      6
      7
    26
    38
    38
   
 
   
PART II – OTHER INFORMATION    
   
 
   
    38
    42
    42
    42
    42
    43
    43
   
 
   
SIGNATURES  
 
  44
  EX-10.1 PURCHASE AGREEMENT DATED 1-23-06
  EX-31.1 SECTION 302 CERTIFICATION OF CEO
  EX-31.2 SECTION 302 CERTIFICATION OF CFO
  EX-32.1 SECTION 906 CERTIFICATION OF CEO
  EX-32.2 SECTION 906 CERTIFICATION OF CFO

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Part I – Financial Information
Item 1. Financial Statements
TRIPLE-S MANAGEMENT CORPORATION AND SUBSIDIARIES
Consolidated Balance Sheets
(Dollar amounts in thousands, except per share data)
                 
    (Unaudited)    
    March 31,   December 31,
    2006   2005
 
ASSETS
               
 
               
Investments and cash:
               
Securities held for trading, at fair value:
               
Equity securities
  $ 81,550       78,215  
Securities available for sale, at fair value:
               
Fixed maturities
    715,337       515,174  
Equity securities
    53,331       51,810  
Securities held to maturity, at amortized cost:
               
Fixed maturities
    21,083       21,129  
Policy loans
    4,888        
Cash and cash equivalents
    48,909       48,978  
 
 
               
Total investments and cash
    925,098       715,306  
 
Premiums and other receivables, net
    154,711       244,038  
Deferred policy acquisition costs and value of business acquired
    104,239       81,568  
Property and equipment, net
    38,544       34,709  
Net deferred tax asset
    498       2,151  
Other assets
    57,073       59,690  
 
 
               
Total assets
  $ 1,280,163       1,137,462  
 
LIABILITIES AND STOCKHOLDERS’ EQUITY
               
 
               
Claim liabilities:
               
Claims processed and incomplete
  $ 147,069       139,694  
Unreported losses
    163,868       143,224  
Unpaid loss-adjustment expenses
    15,402       14,645  
 
 
               
Total claim liabilities
    326,339       297,563  
 
Future policy benefits
    168,457        
Future policy benefits reserve related to funds withheld reinsurance
          118,635  
Unearned premiums
    98,588       95,703  
Policyholder deposits
    54,384       41,738  
Liability to Federal Employees Health Benefits Program
    8,097       4,356  
Accounts payable and accrued liabilities
    119,547       106,468  
Short-term borrowings
          1,740  
Long-term borrowings
    185,317       150,590  
Additional minimum pension liability
    14,133       11,966  
 
 
               
Total liabilities
    974,862       828,759  
 
Stockholders’ equity:
               
Common stock, $40 par value. Authorized 12,500 shares; issued and outstanding 8,911 at March 31, 2006 and 8,904 at December 31, 2005
    356       356  
Additional paid-in capital
    150,408       150,408  
Retained earnings
    166,114       162,964  
Accumulated other comprehensive loss
    (11,577 )     (5,025 )
 
 
               
Total stockholders’ equity
    305,301       308,703  
 
 
               
Total liabilities and stockholders’ equity
  $ 1,280,163       1,137,462  
 
See accompanying notes to unaudited consolidated financial statements.

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TRIPLE-S MANAGEMENT CORPORATION AND SUBSIDIARIES
Consolidated Statements of Earnings (Unaudited)
For the three months ended March 31, 2006 and 2005
(Dollar amounts in thousands, except per share data)
                 
    Three months ended
    March 31,
    2006   2005
 
REVENUE:
               
 
               
Premiums earned, net
  $ 382,104       333,389  
Amounts attributable to self-funded arrangements
    50,806       51,915  
Less amounts attributable to claims under self-funded arrangements
    (47,377 )     (48,540 )
 
 
    385,533       336,764  
Net investment income
    10,050       7,064  
Net realized investment gains
    528       3,314  
Net unrealized investment gain (loss) on trading securities
    2,556       (5,793 )
Other income, net
    1,199       632  
 
 
               
Total revenue
    399,866       341,981  
 
BENEFITS AND EXPENSES:
               
 
               
Claims incurred
    326,684       302,923  
Operating expenses, net of reimbursement for services
    57,730       43,766  
Interest expense
    3,394       1,788  
 
 
               
Total benefits and expenses
    387,808       348,477  
 
Income (loss) before taxes
    12,058       (6,496 )
 
INCOME TAX EXPENSE (BENEFIT):
               
 
               
Current
    2,636       1,221  
Deferred
    41       (2,510 )
 
 
               
Total income taxes
    2,677       (1,289 )
 
 
               
Net income (loss)
  $ 9,381       (5,207 )
 
 
               
Basic net income (loss) per share
  $ 1,053       (585 )
 
See accompanying notes to unaudited consolidated financial statements.

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TRIPLE-S MANAGEMENT CORPORATION AND SUBSIDIARIES
Consolidated Statements of Stockholders’ Equity and
Comprehensive Income (Unaudited)
For the three months
ended March 31, 2006 and 2005
(Dollar amounts in thousands, except per share data)
                 
    2006   2005
 
BALANCE AT JANUARY 1
  $ 308,703       301,433  
 
               
Dividends
    (6,231 )      
Comprehensive income (loss):
               
Net income (loss)
    9,381       (5,207 )
Net unrealized change in investment securities
    (6,644 )     (12,488 )
Net change in fair value of cash flow hedges
    92       337  
 
 
               
Total comprehensive income (loss)
    2,829       (17,358 )
 
 
               
BALANCE AT MARCH 31
  $ 305,301       284,075  
 
See accompanying notes to unaudited consolidated financial statements.

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TRIPLE-S MANAGEMENT CORPORATION AND SUBSIDIARIES
Consolidated Statements of Cash Flows (Unaudited)
For the three months ended March 31, 2006 and 2005
(Dollar amounts in thousands, except per share data)
                 
    Three months ended
    March 31,
    2006   2005
 
CASH FLOWS FROM OPERATING ACTIVITIES:
               
 
               
Premiums collected
  $ 366,287       323,459  
Cash paid to suppliers and employees
    (65,552 )     (44,943 )
Claims, losses and benefits paid
    (305,380 )     (276,277 )
Interest received
    10,462       6,359  
Proceeds from trading securities sold or matured:
               
Fixed maturities sold
          31,946  
Equity securities
    5,866       5,027  
Acquisitions of investments in trading portfolio:
               
Fixed maturities
          (14,463 )
Equity securities
    (5,762 )     (5,116 )
Interest paid
    (3,161 )     (1,509 )
Expense reimbursement from Medicare
    1,155       3,003  
 
 
               
Net cash provided by operating activities
    3,915       27,486  
 
CASH FLOWS FROM INVESTING ACTIVITIES:
               
 
               
Proceeds from investments sold or matured:
               
Securities available for sale:
               
Fixed maturities sold
    4,838       5,038  
Fixed maturities matured
    14,569       206  
Equity securities
    360       2,677  
Securities held to maturity:
               
Fixed maturities matured
    122       290  
Acquisitions of investments:
               
Securities available for sale:
               
Fixed maturities
    (21,844 )     (17,919 )
Equity securities
          (2,821 )
Securities held to maturity:
               
Fixed maturities
          (993 )
Acquisition of business, net of $10,403 of cash acquired
    (27,793 )      
Net disbursements for policy loans
    (109 )      
Capital expenditures
    (3,780 )     (1,338 )
Proceeds from sale of property and equipment
    3       2  
 
 
               
Net cash used in investing activities
    (33,634 )     (14,858 )
 
CASH FLOWS FROM FINANCING ACTIVITIES:
               
 
               
Change in outstanding checks in excess of bank balances
    2,569       8,700  
Payments of short-term borrowings
    (8,652 )     (17,125 )
Proceeds from short-term borrowings
    6,912       17,125  
Payments of long-term borrowings
    (273 )     (273 )
Proceeds from long-term borrowings
    35,000        
Dividends
    (6,231 )      
Proceeds from policyholder deposits
    2,255       3,164  
Surrenders of policyholder deposits
    (1,930 )     (1,166 )
 
 
               
Net cash provided by financing activities
    29,650       10,425  
 
Net (decrease) increase in cash and cash equivalents
    (69 )     23,053  
Cash and cash equivalents at beginning of the period
    48,978       35,115  
 
 
               
Cash and cash equivalents at end of the period
  $ 48,909       58,168  
 
See accompanying notes to unaudited consolidated financial statements.

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TRIPLE-S MANAGEMENT CORPORATION AND SUBSIDIARIES
Notes to Consolidated Financial Statements
March 31, 2006
(Dollar amounts in thousands, except per share data)
(Unaudited)
(1) Basis of Presentation
The accompanying consolidated interim financial statements prepared by Triple-S Management Corporation (TSM) and its subsidiaries (the Corporation) are unaudited, except for the balance sheet information as of December 31, 2005, which is derived from the Corporation’s audited consolidated financial statements, pursuant to the rules and regulations of the United States Securities and Exchange Commission. The consolidated interim financial statements do not include all of the information and the footnotes required by accounting principles generally accepted in the United States of America for complete financial statements. These consolidated interim financial statements should be read in conjunction with the audited consolidated financial statements included in the Corporation’s Annual Report on Form 10-K for the year ended December 31, 2005.
In the opinion of management, all adjustments, consisting of normal recurring adjustments, necessary for a fair presentation of such consolidated interim financial statements have been included. The results of operations for the three months ended March 31, 2006 are not necessarily indicative of the results for the full year.
The Corporation has several significant accounting policies that are disclosed in note 2 of the notes to the audited consolidated financial statements included in the Annual Report on Form 10-K for the year ended December 31, 2005. These significant accounting policies have not changed from those previously disclosed, except for the addition of the following significant accounting policies related to the liability for future policy benefits and the value of business acquired resulting from the acquisition of Great American Life Assurance Company of Puerto Rico (GA Life):
Future Policy Benefits
The liability for future policy benefits has been computed using the level premium method based on estimated future investment yield, mortality, and withdrawal experience. The interest rate assumption is 5.0% for all years in issue. Mortality has been calculated principally on select and ultimate tables in common usage in the industry. Withdrawals have been determined principally on industry tables, modified by the Corporation’s experience.
Value of Business Acquired
The value assigned to the insurance in-force at the date of the acquisition is amortized using methods similar to those used to amortize the deferred policy acquisition costs as disclosed in the Corporation’s Annual Report on Form 10-K as of December 31, 2005.
(2) Recent Accounting Standards
SFAS No. 155, Accounting for Certain Hybrid Financial Instruments , an amendment of FASB Statements No. 133 and 140, was issued in February 2006. This statement amends SFAS No. 133, Accounting for Derivatives and Hedging Activities , and SFAS No. 140, Accounting for Transfers and Servicing of Financial Assets and Extinguishments of Liabilities , and allows an entity to remeasure at fair value a hybrid financial instrument that contains an embedded derivative that otherwise would require bifurcation from the host, if the holder irrevocably elects to account for the whole instrument on a fair value basis. Subsequent changes in the fair value of the instrument would be recognized in earnings. This statement also clarifies

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certain issues included in the amended SFAS No. 133 and SFAS No. 140. SFAS No. 155 is effective for all financial instruments acquired and issued after the beginning of an entity’s first fiscal year that begins after September 15, 2006. The adoption of SFAS No. 155 is not expected to have an impact on the Corporation’s financial statements.
SFAS No. 156, Accounting for Servicing of Financial Assets , an amendment of SFAS No. 140, was issued in March 2006. This statement amends SFAS No. 140, Accounting for Transfers and Servicing of Financial Assets and Extinguishments of Liabilities, with respect to the accounting for separately recognized servicing assets and servicing liabilities. This Statement is effective as of the beginning of the first fiscal year that begins after September 15, 2006. The adoption of SFAS No. 156 is not expected to have an impact on the Corporation’s financial statements.
(3) Segment Information
The operations of the Corporation are conducted principally through four business segments: Health Insurance – Commercial Program, Health Insurance – Reform Program, Property and Casualty Insurance and Life and Disability Insurance. On January 31, 2006 the Corporation completed the acquisition of 100% of the common stock of GA Life. The results of operations and financial position of GA Life are included in the Corporation’s consolidated financial statements for the period following January 31, 2006. The operations of GA Life are included in the Corporation’s Life and Disability Insurance segment along with the operations of Seguros de Vida Triple-S, Inc. (SVTS). Prior to completing the acquisition of GA Life, the operations of SVTS were the only component of the Corporation’s Life and Disability Insurance segment. The following tables summarize the operations by major operating segment for the three months ended March 31, 2006 and 2005:

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TRIPLE-S MANAGEMENT CORPORATION AND SUBSIDIARIES
Notes to Consolidated Financial Statements
March 31, 2006
(Dollar amounts in thousands, except per share data)
(Unaudited)
                                                 
    Operating Segments
    Health   Health                
    Insurance   Insurance   Property   Life and        
    Commercial   Reform   and Casualty   Disability        
    Program   Program   Insurance   Insurance   Other *   Total
 
THREE MONTHS ENDED MARCH 31, 2006
                                               
 
                                               
Premiums earned, net
  $ 211,107       127,496       21,898       21,603             382,104  
Amounts attributable to self-funded arrangements
    50,806                               50,806  
Less: Amounts attributable to claims under self-funded arrangements
    (47,377 )                             (47,377 )
Intersegment premiums earned/service revenues
    1,398             129       78       13,268       14,873  
 
 
    215,934       127,496       22,027       21,681       13,268       400,406  
Net investment income
    3,755       801       2,364       3,010             9,930  
Realized gain (loss) on sale of securities
    485       33       (32 )     42             528  
Unrealized gain on trading securities
    1,914             552       90             2,556  
Other
    1,063       (4 )     54       69             1,182  
 
Total revenue
  $ 223,151       128,326       24,965       24,892       13,268       414,602  
 
 
                                               
Net income
  $ 2,116       3,667       2,659       507       7       8,956  
 
 
                                               
Claims incurred
  $ 190,857       113,882       10,313       11,632             326,684  
 
 
                                               
Operating expenses
  $ 28,401       9,240       11,642       11,390       12,984       73,657  
 
 
                                               
Depreciation expense, included in operating expenses
  $ 760       157       107       135             1,159  
 
 
                                               
Interest expense
  $ 1,240       324             1,285             2,849  
 
 
                                               
Income tax expense
  $ 537       1,213       351       78       277       2,456  
 
*   Includes segments which are not required to be reported separately. These segments include the data processing services organization as well as the third-party administrator of health insurance services.

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TRIPLE-S MANAGEMENT CORPORATION AND SUBSIDIARIES
Notes to Consolidated Financial Statements
March 31, 2006
(Dollar amounts in thousands, except per share data)
(Unaudited)
                                                 
    Operating Segments
    Health   Health                
    Insurance   Insurance   Property   Life and        
    Commercial   Reform   and Casualty   Disability        
    Program   Program   Insurance   Insurance   Other *   Total
 
THREE MONTHS ENDED MARCH 31, 2005
                                               
 
                                               
Premiums earned, net
  $ 184,300       123,140       22,096       3,853             333,389  
Amounts attributable to self-funded arrangements
    51,915                               51,915  
Less: Amounts attributable to claims under self-funded arrangements
    (48,540 )                             (48,540 )
Intersegment premiums earned/service revenues
    1,076                         13,638       14,714  
 
 
    188,751       123,140       22,096       3,853       13,638       351,478  
Net investment income
    3,413       741       2,105       711             6,970  
Realized gain (loss) on sale of securities
    2,103       (25 )     1,176       60             3,314  
Unrealized loss on trading securities
    (4,806 )           (793 )     (194 )           (5,793 )
Other
    188       (5 )     338       62             583  
 
Total revenue
  $ 189,649       123,851       24,922       4,492       13,638       356,552  
 
 
                                               
Net income (loss)
  $ (6,803 )     (911 )     2,658       (414 )     69       (5,401 )
 
 
                                               
Claims incurred
  $ 172,829       116,088       11,373       2,633             302,923  
 
 
                                               
Operating expenses
  $ 24,240       8,914       10,341       1,982       13,405       58,882  
 
 
                                               
Depreciation expense, included in operating expenses
  $ 644       181       107       39             971  
 
 
                                               
Interest expense
  $ 1,058       204             279             1,541  
 
 
                                               
Income tax expense (benefit)
  $ (1,675 )     (444 )     550       12       164       (1,393 )
 
*   Includes segments which are not required to be reported separately. These segments include the data processing services organization as well as the third-party administrator of health of health insurance services.

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TRIPLE-S MANAGEMENT CORPORATION AND SUBSIDIARIES
Notes to Consolidated Financial Statements
March 31, 2006
(Dollar amounts in thousands, except per share data)
(Unaudited)
                                                 
    Operating Segments
    Health   Health                
    Insurance   Insurance   Property   Life and        
    Commercial   Reform   and Casualty   Disability        
    Program   Program   Insurance   Insurance   Other *   Total
 
AS OF MARCH 31, 2006
                                               
 
                                               
Segment assets
  $ 481,275       92,073       305,514       396,893       4,201       1,279,956  
 
Significant noncash item:
                                               
Net change in unrealized gain on securities available for sale
  $ (1,832 )     (355 )     (877 )     (3,512 )           (6,576 )
 
AS OF DECEMBER 31, 2005
                                               
 
                                               
Segment assets
  $ 459,288       82,685       307,228       271,615       4,310       1,125,126  
 
Significant noncash item:
                                               
Net change in unrealized gain on securities available for sale
  $ (12,432 )     (1,301 )     (3,090 )     (1,844 )           (18,667 )
Net change in minimum pension liability
    (2,048 )           (142 )     (76 )     (453 )     (2,719 )
 
*   Includes segments which are not required to be reported separately. These segments include the data processing services organization as well as the third-party administrator of health insurance services.

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TRIPLE-S MANAGEMENT CORPORATION AND SUBSIDIARIES
Notes to Consolidated Financial Statements
March 31, 2006
(Dollar amounts in thousands, except per share data)
(Unaudited)
RECONCILIATION OF REPORTABLE SEGMENT TOTALS
WITH FINANCIAL STATEMENTS
                 
    Three months ended
    March 31,
    2006   2005
 
TOTAL REVENUE
               
 
 
Total revenues for reportable segments
  $ 401,334       342,914  
Total revenues for other segments
    13,268       13,638  
 
 
    414,602       356,552  
 
               
Elimination of intersegment premiums earned
    (1,605 )     (1,076 )
Elimination of intersegment service revenues
    (13,268 )     (13,638 )
Unallocated amount — revenues from external sources
    137       143  
 
 
               
 
    (14,736 )     (14,571 )
 
Consolidated total revenue
  $ 399,866       341,981  
 
 
               
NET INCOME
               
 
               
Net income (loss) for reportable segments
  $ 8,949       (5,470 )
Net income for other segments
    7       69  
 
 
               
 
    8,956       (5,401 )
 
 
               
Elimination of TSM charges:
               
Rent expense
    1,690       1,624  
Interest expense
    1,343       256  
Management fees
    680        
 
 
               
 
    3,713       1,880  
 
 
               
Unallocated amounts related to TSM:
               
General and administrative expenses
    (1,316 )     (1,222 )
Income tax expense
    (221 )     (104 )
Interest expense
    (1,888 )     (503 )
Other revenues from external sources
    137       143  
 
 
               
 
    (3,288 )     (1,686 )
 
 
               
Consolidated net income (loss)
  $ 9,381       (5,207 )
 

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TRIPLE-S MANAGEMENT CORPORATION AND SUBSIDIARIES
Notes to Consolidated Financial Statements
March 31, 2006
(Dollar amounts in thousands, except per share data)
(Unaudited)
RECONCILIATION OF REPORTABLE SEGMENT TOTALS WITH FINANCIAL STATEMENTS
                         
    Three months ended March 31, 2006
    Segment           Consolidated
    Totals   Adjustments *   Totals
 
Claims incurred
  $ 326,684             326,684  
Operating expenses
    73,657       (15,927 )     57,730  
Depreciation expense
    1,159       283       1,442  
Interest expense
    2,849       545       3,394  
Income tax expense
    2,456       221       2,677  
                         
    Three months ended March 31, 2005
    Segment           Consolidated
    Totals   Adjustments *   Totals
 
Claims incurred
  $ 302,923             302,923  
Operating expenses
    58,882       (15,116 )     43,766  
Depreciation expense
    971       277       1,248  
Interest expense
    1,541       247       1,788  
Income tax expense (benefit)
    (1,393 )     104       (1,289 )
 
*   Adjustments represent TSM operations and the elimination of intersegment charges.

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TRIPLE-S MANAGEMENT CORPORATION AND SUBSIDIARIES
Notes to Consolidated Financial Statements
March 31, 2006
(Dollar amounts in thousands, except per share data)
(Unaudited)
RECONCILIATION OF REPORTABLE SEGMENT TOTALS WITH FINANCIAL STATEMENTS
                 
    March 31,   December 31,
    2006   2005
 
ASSETS
               
 
               
Total assets for reportable segments
  $ 1,275,755       1,120,816  
Total assets for other segments
    4,201       4,310  
 
 
               
 
    1,279,956       1,125,126  
 
 
               
Elimination entries — intersegment receivables and others
    (38,456 )     (28,705 )
 
Unallocated amounts related to TSM:
               
Parent cash, cash equivalents and investments
    11,376       11,054  
Parent net property and equipment
    24,479       24,760  
Parent other assets
    2,808       5,227  
 
 
               
 
    38,663       41,041  
 
 
               
Consolidated assets
  $ 1,280,163       1,137,462  
 
OTHER SIGNIFICANT ITEMS
                         
    As of March 31, 2006
    Segment           Consolidated
    Totals   Adjustments *   Totals
 
Significant noncash item — net change in unrealized gain on securities available for sale
  $ (6,576 )     (68 )     (6,644 )
                         
    As of December 31, 2005
    Segment           Consolidated
    Totals   Adjustments *   Totals
 
Significant noncash items:
                       
Net change in unrealized gain on securities available for sale
  $ (18,667 )     (165 )     (18,832 )
Net change in minimum pension liability
    (2,719 )     (69 )     (2,788 )
 
*   Adjustments represent principally TSM operations and the elimination of intersegment charges.

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TRIPLE-S MANAGEMENT CORPORATION AND SUBSIDIARIES
Notes to Consolidated Financial Statements
March 31. 2006
(Dollar amounts in thousands) (Unaudited)
(4) Investment in Securities
The amortized cost for debt securities and equity securities, gross unrealized gains, gross unrealized losses, and estimated fair value for trading, available-for-sale and held-to-maturity securities by major security type and class of security at March 31, 2006 and December 31, 2005, were as follows:
                                 
    March 31, 2006
            Gross   Gross    
    Amortized   unrealized   unrealized   Estimated fair
    cost   gains   losses   value
 
Trading securities:
                               
Equity securities
  $ 70,176       13,323       (1,949 )     81,550  
 
                                 
    March 31, 2006
            Gross   Gross    
    Amortized   unrealized   unrealized   Estimated fair
    cost   gains   losses   value
 
Securities available for sale:
                               
Fixed maturities
  $ 732,732       536       (17,931 )     715,337  
Equity securities
    40,658       14,575       (1,902 )     53,331  
 
 
                               
 
  $ 773,390       15,111       (19,833 )     768,668  
 
                                 
    March 31, 2006
            Gross   Gross  
    Amortized   unrealized   unrealized   Estimated fair
    cost   gains   losses   value
 
Securities held to maturity:
                               
Fixed maturities
  $ 21,083       297       (971 )     20,409  
 
                                 
    December 31, 2005
            Gross   Gross    
    Amortized   unrealized   unrealized   Estimated fair
    cost   gains   losses   value
 
Trading securities:
                               
Equity securities
  $ 69,397       11,378       (2,560 )     78,215  
 
                                 
    December 31, 2005
            Gross   Gross    
    Amortized   unrealized   unrealized   Estimated fair
    cost   gains   losses   value
 
Securities available for sale:
                               
Fixed maturities
  $ 524,287       694       (9,807 )     515,174  
Equity securities
    38,675       14,550       (1,415 )     51,810  
 
 
                               
 
  $ 562,962       15,244       (11,222 )     566,984  
 

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TRIPLE-S MANAGEMENT CORPORATION AND SUBSIDIARIES
Notes to Consolidated Financial Statements
March 31, 2006
(Dollar amounts in thousands, except per share data)
(Unaudited)
                                 
    December 31, 2005
            Gross   Gross    
    Amortized   unrealized   unrealized   Estimated fair
    cost   gains   losses   value
 
Securities held to maturity:
                               
Fixed maturities
  $ 21,129       254       (623 )     20,760  
 
Investment in securities at March 31, 2006 are mostly comprised of U.S. Treasury securities, obligations of U.S. government sponsored agencies and obligations of U.S. government instrumentalities (62.0%), mortgage backed and collateralized mortgage obligations that are U.S. agency-backed (9.6%) and obligations of the government of Puerto Rico and its instrumentalities (6.0%). The remaining 22.4% of the investment portfolio is comprised of equity securities and mutual funds.
The Corporation regularly monitors the difference between the cost and estimated fair value of investments. For investments with a fair value below cost, the process includes evaluating the length of time and the extent to which cost exceeds fair value, the prospects and financial condition of the issuer, and the Corporation’s intent and ability to retain the investment to allow for recovery in fair value, among other factors. 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 fair value solely due to changes in interest rates, impairment may not be appropriate. If after monitoring and analyzing, the Corporation 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. The impairment is charged to operations and a new cost basis for the security is established. During the three months ended March 31, 2006 the Corporation recognized an other-than-temporary impairment amounting to $388 on one of its equity securities classified as available for sale.
The unrealized losses on investments were mainly caused by interest rate increases and market fluctuations. Because the Corporation has the ability and intent to hold these investments until a market price recovery or maturity, these investments are not considered other-than-temporarily impaired.

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TRIPLE-S MANAGEMENT CORPORATION AND SUBSIDIARIES
Notes to Consolidated Financial Statements
March 31, 2006
(Dollar amounts in thousands, except per share data)
(Unaudited)
(5) Premiums and Other Receivables
Premiums and other receivables as of March 31, 2006 and December 31, 2005 were as follows:
                 
    March 31,   December 31,
    2006   2005
 
Premiums
  $ 75,834       53,391  
Self-funded group receivables
    22,108       21,620  
FEHBP
    11,747       9,491  
Accrued interest
    8,051       5,074  
Agents balances
    3,049        
Funds withheld reinsurance receivable
          118,635  
Reinsurance recoverable
    35,086       33,915  
Other
    12,392       14,152  
 
 
               
 
    168,267       256,278  
 
Less allowance for doubtful receivables:
               
Premiums
    8,365       7,792  
Other
    5,191       4,448  
 
 
               
 
    13,556       12,240  
 
 
               
Total premiums and other receivables
  $ 154,711       244,038  
 
(6) Claim Liabilities
The activity in the total claim liabilities for the three months ended March 31, 2006 and 2005 is as follows:
                 
    Three months ended March 31,
    2006   2005
 
Claim liabilities at beginning of period
  $ 297,563       279,325  
Reinsurance recoverable on claim liabilities
    (28,720 )     (26,555 )
 
 
               
Net claim liabilities at beginning of period
    268,843       252,770  
 
 
               
Claim liabilities acquired from GA Life
    8,771        
 
               
Incurred claims and loss-adjustment expenses:
               
Current period insured events
    316,804       297,517  
Prior period insured events
    4,460       5,406  
 
 
               
Total
    321,264       302,923  
 
 
               
Payments of losses and loss-adjustment expenses:
               
Current period insured events
    167,711       137,351  
Prior period insured events
    133,859       138,995  
 
 
               
Total
    301,570       276,346  
 
 
               
Net claim liabilities at end of period
    297,308       279,347  
Reinsurance recoverable on claim liabilities
    29,031       25,285  
 
 
               
Claim liabilities at end of period
  $ 326,339       304,632  
 
As a result of changes in estimates of insured events in prior periods, the amounts included as incurred claims for prior period insured events differ from anticipated claims incurred. The amount in the incurred claims and loss-adjustment expenses for prior period insured events for the three months ended

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TRIPLE-S MANAGEMENT CORPORATION AND SUBSIDIARIES
Notes to Consolidated Financial Statements
March 31, 2006
(Dollar amounts in thousands, except per share data)
(Unaudited)
March 31, 2006 and 2005 is due to an unfavorable development of the claim liabilities attributed to higher than expected cost per service and utilization trends.
(7) Long-term Borrowings
A summary of the Corporation’s long-term borrowings at March 31, 2006 and December 31, 2005 is as follows:
                 
    March 31,   December 31,
    2006   2005
 
Secured loan payable of $20,000, payable in various different installments up to August 31, 2007, with interest payable on a monthly basis at a rate reset periodically of 130 basis points over LIBOR selected (which was 5.87% and 5.71% at March 31, 2006 and December 31, 2005, respectively)
  $ 11,500       11,500  
Senior unsecured notes payable of $50,000 due September 2019. Interest is payable semiannually at a fixed rate of 6.30%.
    50,000       50,000  
Senior unsecured notes payable of $60,000 due December 2020. Interest is payable monthly at a fixed rate of 6.60%.
    60,000       60,000  
Senior unsecured notes payable of $35,000 due January 2021. Interest is payable monthly at a fixed rate of 6.70%.
    35,000        
Secured loan payable of $41,000, payable in monthly installments of $137 up to July 1, 2024, plus interest at a rate reset periodically of 100 basis points over LIBOR selected (which was 5.63% and 5.29% at March 31, 2006 and December 31, 2005, respectively)
    28,817       29,090  
 
                 
Total long-term borrowings
  $ 185,317       150,590  
 
On January 23, 2006 the Corporation issued and sold $35.0 million of its 6.7% senior unsecured notes payable due January 2021 (the 6.7% notes). The 6.7% notes were privately placed to various accredited institutional investors. The notes pay interest each month beginning on March 1, 2006, until such principal becomes due and payable. These notes can be prepaid after five years at par, in full or in part, as determined by the Corporation. Debt issuance costs amounting to $306 were deferred and will be amortized over the term of the notes and are reported as other assets in the accompanying consolidated balance sheets.
(8) Comprehensive Income
The accumulated balances for each classification of comprehensive income are as follows:
                                 
                            Accumulated
    Unrealized   Minimum           other
    gains on   pension   Cash flow   comprehensive
    securities   liability   hedges   income
 
BALANCE AT JANUARY 1
  $ 3,217       (8,613 )     371       (5,025 )
Net current period change
    (6,644 )           92       (6,552 )
 
                                 
BALANCE AT MARCH 31
  $ (3,427 )     (8,613 )     463       (11,577 )
 

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TRIPLE-S MANAGEMENT CORPORATION AND SUBSIDIARIES
Notes to Consolidated Financial Statements
March 31. 2006
(Dollar amounts in thousands)
(Unaudited)
(9) Income Taxes
Under Puerto Rico income tax law, the Corporation is not allowed to file consolidated tax returns with its subsidiaries.
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 statements 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. Quarterly income taxes are calculated using the effective tax rate determined based on the income forecasted for the full fiscal year.
(10) Pension Plan
The components of net periodic benefit cost for the three months ended March 31, 2006 and 2005 were as follows:
                 
    Three months ended
    March 31,
    2006   2005
 
Components of net periodic benefit cost:
               
Service cost
  $ 1,370       1,143  
Interest cost
    1,175       1,030  
Expected return on assets
    (991 )     (843 )
Amortization of prior service cost
    12       12  
Amortization of actuarial loss
    602       490  
 
 
               
Net periodic benefit cost
  $ 2,168       1,832  
 
Employer contributions
The Corporation disclosed in its audited consolidated financial statements for the year ended December 31, 2005 that it expected to contribute $6,000 to its pension program in 2006. As of March 31, 2006, no contributions have been made. The Corporation currently anticipates contributing approximately $6,000 to fund the pension program in 2006.
(11) Net Income (Loss) Available to Stockholders and Net Income (Loss) per Share
The Corporation presents only basic earnings per share, which amount consists of the net income (loss) that is available to common stockholders divided by the weighted-average number of common shares outstanding for the period.
The following table sets forth the computation of basic net income (loss) per share for the three months ended March 31, 2006 and 2005:

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TRIPLE-S MANAGEMENT CORPORATION AND SUBSIDIARIES
Notes to Consolidated Financial Statements
March 31, 2006
(Dollar amounts in thousands, except per share data)
(Unaudited)
                 
    Three months ended
    March 31,
    2006   2005
 
Numerator for basic earnings per share:
               
Net income (loss) available to stockholders
  $ 9,381       (5,207 )
 
 
               
Denominator for basic earnings per share:
               
Weighted average of outstanding common shares
    8,906       8,904  
 
 
               
Basic net income (loss) per share
  $ 1,053       (585 )
 
(12) Contingencies
  (a)   As of March 31, 2006, the Corporation is a defendant in various lawsuits arising in the ordinary course of business. Management believes, based on the opinion of its legal counsel, that the aggregate liabilities, if any, arising from such actions would not have a material adverse effect on the consolidated financial position and results of operations of the Corporation.
 
  (b)   Drs. Carlyle Benavent and Ibrahim Pérez (the plaintiffs) caused the initiation of an administrative proceeding before the Puerto Rico Insurance Commissioner against TSI and TSM alleging the illegality of the repurchase and subsequent sale of 1,582 shares of TSI’s common stock due to the fact that the ultimate purchasers of said shares were selected on an improper and selective basis by the Corporation in violation of the Puerto Rico Insurance Code. The plaintiffs alleged that they were illegally excluded from participation in the sale of shares by TSI due to the illegally selective nature of the sale of shares and that, consequently, the sale of shares should be eliminated.
 
      In December 1996, the Commissioner of Insurance issued an order to annul the sale of the 1,582 shares that TSI had repurchased from the estate of deceased stockholders. TSI contested such order through an administrative and judicial review process. Consequently, the sale of 1,582 shares was cancelled and the purchase price was returned to each former stockholder. In the year 2000, the Commissioner of Insurance issued a pronouncement providing further clarification of the content and effect of the order. This order also required that all corporate decisions undertaken by TSI through the vote of its stockholders of record, be ratified in a stockholders’ meeting or in a subsequent referendum. In November 2000, TSM, as the sole stockholder of TSI, ratified all such decisions. Furthermore, on November 19, 2000, TSM held a special stockholders’ meeting, where a ratification of these decisions was undertaken except for the resolution related to the approval of the reorganization of TSI and its subsidiaries. This resolution did not reach the two thirds majority required by the order because the number of shares that were present and represented at the meeting was below such amount (total shares present and represented in the stockholders’ meeting was 64%). As stipulated in the order, TSM began the process to conduct a referendum among its stockholders in order to ratify such resolution. The process was later suspended because upon further review of the scope of the order, the Commissioner of Insurance issued an opinion in a letter dated January 8, 2002 which indicated that the ratification of the corporate reorganization was not required.
 
      In another letter dated March 14, 2002, the Commissioner of Insurance stated that the ratification of the corporate reorganization was not required and that TSI had complied with the Commissioner’s order of December 6, 1996 related to the corporate reorganization. Thereafter, the plaintiffs filed a petition for review of the Commissioner’s determination before the Puerto Rico Circuit Court of Appeals. Such petition was opposed by TSI and by the Commissioner of Insurance.

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TRIPLE-S MANAGEMENT CORPORATION AND SUBSIDIARIES
Notes to Consolidated Financial Statements
March 31, 2006
(Dollar amounts in thousands, except per share data)
(Unaudited)
      Pursuant to that review, on September 24, 2002, the Puerto Rico Circuit Court of Appeals issued an order requiring the Commissioner of Insurance to order that a meeting of shareholders be held to ratify TSI’s corporate reorganization and the change of name of TSI from Seguros de Servicios de Salud de Puerto Rico, Inc. to Triple-S, Inc. The Puerto Rico Circuit Court of Appeals based its decision on administrative and procedural issues directed at the Commissioner of Insurance. The Commissioner of Insurance filed a motion of reconsideration with the Puerto Rico Circuit Court of Appeals on October 11, 2002. TSM and TSI also filed a motion of reconsideration.
 
      On October 25, 2002, the Puerto Rico Circuit Court of Appeals dismissed the Commissioner of Insurance’s Motion for Reconsideration and ordered the plaintiffs to reply to TSI’s Motion of Reconsideration.
 
      On May 18, 2003, the Puerto Rico Circuit Court of Appeals granted TSI’s and TSM’s Motion of Reconsideration. The Puerto Rico Circuit Court of Appeals held that the Commissioner of Insurance had the authority to waive the celebration of a referendum to ratify TSI’s reorganization and that therefore the reorganization of TSI, inasmuch as the 1,582 shares annulled were not decisive, was approved by the stockholders.
 
      On June 26, 2003, the plaintiffs presented a writ of certiorari before the Supreme Court of Puerto Rico. TSI and TSM filed a motion opposing the issuance of the writ. The writ was issued by the Supreme Court on August 22, 2003 when it ordered the Puerto Rico Circuit Court of Appeals to transmit the record of the case. On December 1, 2003, the plaintiffs filed a motion submitting their case on the basis of their original petition. TSI and TSM filed its brief on December 30, 2003, while the Commissioner of Insurance, in turn, filed a separate brief on December 31, 2003. On June 24, 2004 the Supreme Court of Puerto Rico ordered the plaintiffs to file a brief in support of their allegations. The case is still pending before the Supreme Court of Puerto Rico. It is the opinion of the management and its legal counsels that the corporate reorganization as approved is in full force and effect.
 
  (c)   On September 4, 2003, José Sánchez and others filed a putative class action complaint against the Corporation, present and former directors of TSM and TSI, and others, in the United States District Court for the District of Puerto Rico, alleging violations under the Racketeer Influenced and Corrupt Organizations Act, better known as the RICO Act. The suit, among other allegations, alleges a scheme to defraud the plaintiffs by acquiring control of TSI through illegally capitalizing TSI and later converting it to a for-profit corporation and depriving the stockholders of their ownership rights. The plaintiffs base their later allegations on the supposed decisions of TSI’s board of directors and stockholders, allegedly made in 1979, to operate with certain restrictions in order to turn TSI into a charitable corporation, basically forever. On March 4, 2005 the Court issued an Opinion and Order. In this Opinion and Order, of the twelve counts included in the complaint, eight counts were dismissed for failing to assert an actionable injury; six of them for lack of standing and two for failing to plead with sufficient particularity in compliance with the Rules. All shareholder allegations, including those described above, were dismissed in the Opinion and Order. The remaining four counts were found standing, in a limited way, in the Opinion and Order. The parties finished class certification discovery and fully briefed the issue of class certification. In addition, the defendants are evaluating the dismissal of the surviving claims. While waiting for the Court’s decision on the issue of class certification, the Court sua sponte , issued an Order to Show Cause (OTC) to plaintiffs as to why the complaint should not be dismissed with prejudice. The Court’s OTC is predicated on the parties’ submissions about class certification. The Court then granted plaintiffs leave to file a sur-reply, which they did on April

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TRIPLE-S MANAGEMENT CORPORATION AND SUBSIDIARIES
Notes to Consolidated Financial Statements
March 31, 2006
(Dollar amounts in thousands, except per share data)
(Unaudited)
      21, 2006. In its OTC the Court indicated that it will decide first the sustainability of the complaint before deciding plaintiffs’ request for class certification. The parties are in anticipation of the Court’s ruling on the OTC. On May 4, 2006, the Court issued an Opinion and Order which entered a summary judgment in favor of the Corporation and the case was dismissed by the Court. The plaintiffs have ten (10) business days to file for reconsideration with the Court, they may also request additional findings from the Court, and/or they have thirty (30) days to appeal the judgment to the United States Court of Appeals for the First Circuit.
  (d)   On April 24, 2002, Octavio Jordán, Agripino Lugo, Ramón Vidal, and others filed a suit against TSM, TSI and others in the Court of First Instance for San Juan, Superior Section, alleging, among other things, violations by the defendants of provisions of the Puerto Rico Insurance Code, anti-monopolistic practices, unfair business practices and damages in the amount of $12.0 million. They also requested that TSM sell shares to them. After a preliminary review of the complaint, it appears that many of the allegations brought by the plaintiffs have been resolved in favor of TSM and TSI in previous cases brought by the same plaintiffs in the United States District Court for the District of Puerto Rico and by most of the plaintiffs in the local courts. The defendants, including TSM and TSI answered the complaint, filed a counterclaim and filed several motions to dismiss this claim. On February 18, 2005 the plaintiffs informed their intention to amend the complaint and the Court granted them 45 days to do so and 90 days to the defendants to file the corresponding motion to dismiss. On May 9, 2005 the plaintiffs amended the complaint and the defendants are preparing the corresponding motions to dismiss this amended complaint. The plaintiffs amended the complaint to allege causes of action similar to those dismissed by the United States District Court for the District of Puerto Rico in the Sánchez case. Defendants moved to dismiss the amended complaint. Plaintiffs have notified their opposition to some of the defendants’ motion to dismiss, and the defendants filed the corresponding replies. On January 25, 2006, the court held a hearing to argue the dispositive motions. On March 16, 2006 the Court held another hearing to hear additional argument on the same motions. The Court set a final hearing for July 6, 2006.
 
  (e)   On May 22, 2003 a putative class action suit was filed by Kenneth A. Thomas, M.D. and Michael Kutell, M.D., on behalf of themselves and all others similarly situated and the Connecticut State Medical Society against the Blue Cross and Blue Shield Association (BCBSA) and multiple other insurance companies including TSI. The case is pending before the U.S. District Court for the Southern District of Florida, Miami District.
 
      The individual plaintiffs bring this action on behalf of themselves and a class of similarly situated physicians seeking redress for alleged illegal acts of the defendants, which they allege have resulted in a loss of their property and a detriment to their business, and for declaratory and injunctive relief to end those practices and prevent further losses. Plaintiffs alleged that the defendants, on their own and as part of a common scheme, systematically deny, delay and diminish the payments due to doctors so that they are not paid in a timely manner for the covered, medically necessary services they render.
 
      The class action complaint alleges that the health care plans are the agents of BCBSA licensed entities, and as such have committed the acts alleged above and acted within the scope of their agency, with the consent, permission, authorization and knowledge of the others, and in furtherance of both their interest and the interests of other defendants.
 
      Management believes that TSI was brought to this litigation for the sole reason of being associated with the BCBSA. However, on June 18, 2004 the plaintiffs moved to amend the complaint to

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TRIPLE-S MANAGEMENT CORPORATION AND SUBSIDIARIES
Notes to Consolidated Financial Statements
March 31, 2006
(Dollar amounts in thousands, except per share data)
(Unaudited)
      include the Colegio de Médicos y Cirujanos de Puerto Rico (a compulsory association grouping all physicians in Puerto Rico), Marissel Velázquez, MD, President of the Colegio de Médicos y Cirujanos de Puerto Rico, and Andrés Meléndez, MD, as plaintiffs against TSI. Later Marissel Velázquez, MD voluntarily dismissed her complaint against TSI.
 
      TSI, along with the other defendants, moved to dismiss the complaint on multiple grounds, including but not limited to arbitration and applicability of the McCarran Ferguson Act.
 
      The Court issued a 90-day stay to allow the parties to discuss their differences and come to amicable agreement. The stay expired on March 7, 2006. Upon the expiration of the stay, both plaintiffs and defendants agreed to request the Court to extend the stay until April 21, 2006. The stay expired and the parties informed the Court that they need additional time to iron out the details of an amicable solution. The Court has not reacted to the parties’ joint request. If the Court denies another stay, the parties will have to continue the proceedings where they were left before the issuance of the first stay. In the meantime, the Court issued an Agreed Order on the Preservation of Records. This order supersedes the parties’ existing record-keeping policies in regards to the documents and materials specified in the order. The purpose of the order is to avoid the disposition of documents that might be relevant for the case.
 
  (f)   On December 8, 2003 a putative class action was filed by Jeffrey Solomon, MD and Orlando Armstrong, MD, on behalf of themselves and all other similarly situated and the American Podiatric Medical Association, Florida Chiropractic Association, California Podiatric Medical Association, Florida Podiatric Medical Association, Texas Podiatric Medical Association, and Independent Chiropractic Physicians, against the BCBSA and multiple other insurance companies, including TSI and all members of the BCBSA. The case is still pending before the United States District Court for the Southern District of Florida, Miami District.
 
      The lawsuit challenges many of the same practices as the litigation described in the immediately preceding item.
 
      Management believes that TSI was made a party to this litigation for the sole reason that TSI is associated with the BCBSA.
 
      On June 25, 2004, plaintiffs amended the complaint but the allegations against TSI did not vary. TSI along with the other defendants, moved to dismiss the complaint on multiple grounds, including but not limited to arbitration and applicability of the McCarran Ferguson Act.
 
      The Court issued a 90-day stay to allow the parties to discuss their differences and come to an amicable agreement. The stay expired on March 7, 2006. Upon the expiration of the stay, both plaintiffs and defendants agreed to request the Court to extend the stay until April 21, 2006. The stay expired and the parties informed the Court that they need additional time to iron out the details of an amicable solution. The Court has not reacted to the parties’ joint request. If the Court denies another stay, the parties will have to continue the proceedings where they were left before the issuance of the first stay. In the meantime, the Court issued an Agreed Order on the Preservation of Records. This order supersedes the parties’ existing record-keeping policies in regards to the documents and materials specified in the order. The purpose of the order is to avoid the disposition of documents that might be relevant for the case.
(12) Acquisition

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TRIPLE-S MANAGEMENT CORPORATION AND SUBSIDIARIES
Notes to Consolidated Financial Statements
March 31, 2006
(Dollar amounts in thousands, except per share data)
(Unaudited)
Effective January 31, 2006, the Corporation acquired 100% of the common stock of Great American Life Assurance Company of Puerto Rico (GA Life). As a result of this acquisition, the Corporation became one of the leading providers of life insurance policies in Puerto Rico. The acquisition was accounted by the Corporation in accordance with the provisions of SFAS No. 141, Business Combinations . The results of operations and financial condition of GA Life are included in the accompanying unaudited consolidated financial statements for the period following the effective date of the acquisition. The aggregate purchase price of the acquired entity amounted to $38,196; of this amount $37,500 were paid in cash on January 31, 2006 and $696 are direct costs related to the acquisition.
The following table summarizes the estimated fair value of the assets acquired and liabilities assumed at the date of acquisition. The Corporation is still in the process of evaluating the net assets acquired and of obtaining third-party valuations of certain intangible assets. Consequently, the allocation of the purchase price is preliminary and subject to revision based on the outcome of the ongoing evaluation of these assets and liabilities.
         
Current assets
  $ 219,747  
Property and equipment
    1,500  
Value of business acquired
    21,973  
 
Total assets acquired
    243,220  
 
Total liabilities assumed
    205,024  
 
 
       
Net assets acquired
  $ 38,196  
 
The estimated fair value of the value of business acquired was actuarially determined by discounting after-tax profits at a risk rate of return equal to approximately 12%. After-tax profits were forecasted based upon models of the in force, actual invested assets as of acquisition date and best-estimate actuarial assumptions regarding premium income, claims, persistency, expenses and investment income accruing from invested assets plus reinvestment of positive cash flows. The best-estimate actuarial assumptions were based upon GA Life’s recent experience in each of its major life and health insurance product lines. The amount of value of business acquired is to be amortized, considering interest, over the anticipated premium-paying period of the related policies in proportion to the ratio of annual premium revenue to the expected total premium revenue to be received over the life of the policies.
The following unaudited pro forma financial information presents the combined results of operations of the Corporation and GA Life as if the acquisition had occurred at January 1, 2006 and 2005. The pro forma results of operations for 2006 combine the results of the Corporation for 2006 and the historical results of GA Life for the one month period ended January 31, 2006. The unaudited pro forma financial information is not intended to represent or be indicative of the Corporation’s consolidated results of operations that would have been reported had the acquisition been completed as of the beginning of the periods presented and should not be taken as indicative of the Corporation’s future consolidated results of operations.
                 
    Three months ended
    March 31,
    2006   2005
 
Total revenue
  $ 407,149       363,240  
 
 
               
Net income
  $ 9,698       (3,667 )
 
 
               
Basic net income (loss) per share
  $ 1,089       (412 )
 

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TRIPLE-S MANAGEMENT CORPORATION AND SUBSIDIARIES
Notes to Consolidated Financial Statements
March 31, 2006
(Dollar amounts in thousands, except per share data)
(Unaudited)
(13) Reconciliation of Net Income to Net Cash Provided by Operating Activities
A reconciliation of net income to net cash provided by operating activities is as follows:
                 
    Three months ended
    March 31,
    2006   2005
 
Net income (loss)
  $ 9,381       (5,207 )
 
 
               
Adjustments to reconcile net income to net cash provided by operating expenses:
               
 
               
Depreciation and amortization
    1,442       1,248  
Amortization of investment discounts
    245       194  
Accretion in value of securities
    (182 )     (106 )
Increase (decrease) in provision for doubtful receivables
    451       (100 )
Increase (decrease) in net deferred taxes
    41       (2,506 )
Gain on sale of securities
    (528 )     (3,314 )
Unrealized gain (loss) of trading securities
    (2,556 )     5,793  
Proceeds from trading securities sold:
               
Fixed maturities
          31,946  
Equity securities
    5,866       5,027  
Acquisition of securities in trading portfolio:
               
Fixed maturities
          (14,463 )
Equity securities
    (5,762 )     (5,116 )
Loss on sale of property and equipment
          (2 )
(Increase) decrease in assets:
               
Premiums receivable
    (23,969 )     (11,081 )
Accrued interest receivable
    349       (793 )
Agents balances
    (94 )      
Reinsurance receivable
    (348 )     1,339  
Other receivables
    1,782       2,717  
Deferred policy acquisition costs
    (698 )     460  
Prepaid income tax
    2,555        
Other assets
    762       (769 )
Increase (decrease) in liabilities:
               
Claims processed and incomplete
    2,661       3,705  
Unreported losses
    16,475       21,271  
Unpaid loss-adjustment expenses
    457       331  
Future policy benefits
    2,059        
Unearned premiums
    585       (3,393 )
Policyholder deposits
    416       279  
Liability to FEHBP
    3,741       988  
Accounts payable and accrued liabilities
    (11,216 )     (2,179 )
Income tax payable
          1,217  
 
 
               
Net cash provided by operating activities
  $ 3,915       27,486  
 

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Item 2. Management’s Discussion and Analysis of Financial Condition and Results of Operations
The Management’s Discussion and Analysis of Financial Condition and Results of Operations included in this Quarterly Report on Form 10-Q is intended to update the reader on matters affecting the financial condition and results of operations of Triple-S Management Corporation (TSM) and its subsidiaries (the Corporation) for the three months ended March 31, 2006. Therefore, the following discussion should be read in conjunction with the audited consolidated financial statements and notes thereto included in the Annual Report on Form 10-K filed with the United States Securities and Exchange Commission as of and for the year ended December 31, 2005.
Cautionary Statement Regarding Forward-Looking Information
This Quarterly Report on Form 10-Q and other publicly available documents of the Corporation may include statements that constitute “forward-looking statements” within the meaning of the Private Securities Litigation Reform Act of 1995, including, among other things: statements concerning the financial condition, results of operations and business of the Corporation. These statements are not historical, but instead represent the Corporation’s belief regarding future events, any of which, by their nature, are inherently uncertain and outside of the Corporation’s control. These statements may address, among other things, future financial results, strategy for growth, and market position. It is possible that the Corporation’s actual results and financial condition may differ, possibly materially, from the anticipated results and financial condition indicated in these forward-looking statements. The factors that could cause actual results to differ from those in the forward-looking statements are discussed throughout this form. The Corporation is not under any obligation to update or alter any forward-looking statement (and expressly disclaims any such obligations), whether as a result of new information, future events or otherwise. Factors that may cause actual results to differ materially from those contemplated by such forward looking statements include, but are not limited to, rising healthcare costs, business conditions and competition in the different insurance segments, government action and other regulatory issues.
Structure of the Organization
TSM is incorporated under the laws of the Commonwealth of Puerto Rico. It is the holding company of several entities, through which it offers a wide range of insurance products and services. These insurance products and services are offered through the following TSM wholly-owned subsidiaries:
    Triple-S, Inc. (TSI), a health insurance company serving two major segments: the Commercial Program and the Commonwealth of Puerto Rico Healthcare Reform Program (the Healthcare Reform);
 
    Seguros Triple-S, Inc. (STS), a property and casualty insurance company;
 
    Great American Life Assurance Company of Puerto Rico (GA Life) a life insurance company; and
 
    Seguros de Vida Triple-S, Inc. (SVTS), a life and disability insurance and annuity products company.
In addition to the insurance subsidiaries mentioned above, TSM has the following other wholly-owned subsidiaries: Interactive Systems, Inc. (ISI) and Triple-C, Inc. (TCI). ISI provides data processing services to TSM and its subsidiaries. TCI is currently engaged as the third-party administrator in the administration of the Corporation’s Healthcare Reform segment. It also provides healthcare advisory services and other health-related services to TSI and other third parties.

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Recent Developments
Puerto Rico’s Economy
The government of Puerto Rico has announced a lack of current budgetary funds to complete this fiscal year ending June 30, 2006 and that the legislative branch has not authorized a budget loan from the Government Development Bank. Due to this situation, the government is in a partial temporary shut-down since May 1, 2006 until the executive and legislative branches reach an agreement as to how to provide the necessary funds to cover expenses. Although the request of the government is a loan, both the legislative and executive branches have been discussing a number of possibilities to raise additional funds, including additional taxes and a tax reform based on consumption.
As disclosed in Item 1A “Risk Factors” of the Annual Report on Form 10-K as of December 31, 2005, the Corporation has a large concentration of its business in the government’s healthcare reform program, which comprise the Corporation’s Health Insurance — Reform segment. Total premiums generated from the Health Insurance — Reform segment represented 32.1% of the Corporation’s consolidated total premiums during the three months ended March 31, 2006. Until the legislative and executive branches of the government can agree over issues of budget and tax reform, the government could implement measures that would delay the payments to its vendors and service providers and/or cancel certain contracts. If this situation is resolved before June 30, 2006, the government expects to be able to pay its debtors as usual. The government has informed that they expect to be able to pay 80% of the Healthcare Reform premiums billed during the time it takes to resolve this situation; the remaining amount is expected to be paid during July 2006. If the government determines to cancel the healthcare reform contracts, it could adversely affect the Corporation’s operating results, significantly decreasing its volume of premiums, claims and operating expenses. The cancellation of the reform contracts could result in an increase in costs due to the need to downsize some of the operations of the Health Insurance — Reform segment.
Various rating agencies have placed the rating of the government’s debt on a watchlist for possible ratings downgrade. If this happens, the rating of some of the Corporation’s investment in obligations of the government of Puerto Rico and its instrumentalities will be affected. As of March 31, 2006 the Corporation has $52.4 million invested in obligations of the government of Puerto Rico and its instrumentalities. On May 8, 2006, one rating agency downgraded to non-investment grade some of the debt issues of the government. As of March 31, 2006, approximately $46.0 million of the Corporation’s investment in obligations of the government of Puerto Rico and its instrumentalities are now considered non-investment grade by this rating agency.
Recent Accounting Standards
For a description of recent accounting standards, see note 2 to the unaudited consolidated financial statements included in this quarterly report on Form 10-Q.
Significant Transactions
Effective January 31, 2006, TSM completed the acquisition of 100% of the common stock of GA Life for $37.5 million. As a result of this acquisition, the Corporation became one of the leading providers of life insurance policies in Puerto Rico. After its acquisition, GA Life along with SVTS form the Corporation’s Life and Disability Insurance segment. During 2006, TSM expects to merge the operations of GA Life with those of SVTS after receiving required regulatory approvals. GA Life’s results of operations and financial condition are included in the Corporation’s consolidated financial statements included in this Quarterly Report on Form 10-Q for the period following January 31. 2006.
The historical results of operations of the pre-acquisition entities and “comparable basis” information for the three months ended March 31, 2005 are included in the following tables. Comparable basis information was determined by adding the historical statements of earnings for the Corporation and GA Life. Comparable basis information is presented in order to provide investors with a more meaningful comparison to the current period due to the acquisition of GA Life. Comparable basis is not calculated in

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accordance with GAAP and is not intended to represent or be indicative of the results of operations of the Corporation that would have been reported had the acquisition been completed as of January 31, 2005.
Consolidated
                         
    Three months ended March 31, 2005
                    Comparable
(Dollar amounts in thousands)   TSM   GA Life   Basis
 
REVENUE:
                       
Premiums earned, net
  $ 333,389       12,294       345,683  
Amounts attributable to self-funded arrangements
    51,915             51,915  
Less amounts attributable to claims under self-funded arrangements
    (48,540 )           (48,540 )
 
 
    336,764       12,294       349,058  
Net investment income
    7,064       1,958       9,022  
Net realized investment gains (losses)
    3,314       (375 )     2,939  
Net unrealized investment loss on trading securities
    (5,793 )           (5,793 )
Other income, net
    632             632  
 
Total revenue
    341,981       13,877       355,858  
 
BENEFITS AND EXPENSES:
                       
Claims incurred
    302,923       6,718       309,641  
Operating expenses, net of reimbursement for services
    43,766       5,455       49,221  
Interest expense
    1,788             1,788  
 
Total benefits and expenses
    348,477       12,173       360,650  
 
Income (loss) before taxes
    (6,496 )     1,704       (4,792 )
 
INCOME TAX EXPENSE (BENEFIT):
                       
Current
    1,221       123       1,344  
Deferred
    (2,510 )     (396 )     (2,906 )
 
Total income taxes
    (1,289 )     (273 )     (1,562 )
 
Net income (loss)
  $ (5,207 )     1,977       (3,230 )
 
Basic net loss per share
  $ (585 )             (363 )
 
Life and Disability Insurance Segment
                         
    Three months ended March 31, 2005
                    Comparable
(Dollar amounts in thousands)   SVTS   GA Life   Basis
 
Net earned premiums and commission income:
                       
Earned premiums
                       
Life
  $ 2,202       9,806       12,008  
Disability
    3,354       26       3,380  
Cancer and other dreaded diseases
    213       2,781       2,994  
 
Total earned premiums
    5,769       12,613       18,382  
 
Earned premiums ceded
    (2,023 )     (319 )     (2,342 )
 
Net earned premiums
    3,746       12,294       16,040  
 
Commission income on reinsurance
    107             107  
 
Net premiums earned
  $ 3,853       12,294       16,147  
 
Claims incurred
  $ 2,633       6,718       9,351  
Operating expenses
    1,982       5,455       7,437  
 
Total underwriting costs
  $ 4,615       12,173       16,788  
 
Underwriting income (loss)
  $ (762 )     121       (641 )
 

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General Information
Substantially all of the revenues of the Corporation are generated from premiums earned and investment income. Claims incurred include the payment of benefits and losses, mostly to physicians, hospitals and other service providers, and to policyholders. A portion of the claims incurred for each period consists of a management and actuarial estimate of claims incurred but not reported to the segment during the period. Each segment’s results of operations depend largely on their ability to accurately predict and effectively manage these claims. Operating expenses comprise general, selling, commission, depreciation and payroll and payroll related expenses.
The Corporation (on a consolidated basis and for each reportable segment), along with most insurance entities, uses the loss ratio, the expense ratio and the combined ratio as measures of performance. The loss ratio is computed as claims incurred divided by the premiums earned, net and fee revenue. The expense ratio is computed as operating expenses divided by the premiums earned, net and fee revenue. The combined ratio is the sum of the loss ratio and the expense ratio. These ratios are relative measurements that describe, for every $100 of premiums earned, net and fee revenue, the costs of claims and operating expenses. A combined ratio below 100 demonstrates underwriting profit; a combined ratio above 100 demonstrates underwriting loss.
Consolidated Operating Results
The analysis in this section provides an overall view of the consolidated statements of operations and key financial information. Further details of the results of operations of each reportable segment are included in the analysis of operating results for the respective segments.
                         
    Three months ended March 31,
                    Comparable
(dollar amounts in thousands)   2006   2005   Basis 2005
 
Consolidated earned premiums, net and fee revenue
  $ 385,533       336,764       349,058  
 
Consolidated claims incurred
  $ 326,684       302,923       309,641  
Consolidated operating expenses
    57,730       43,766       49,221  
 
Consolidated operating costs
  $ 384,414       346,689       358,862  
 
Consolidated loss ratio
    84.7 %     90.0 %     88.7 %
Consolidated expense ratio
    15.0 %     13.0 %     14.1 %
 
Consolidated combined ratio
    99.7 %     103.0 %     102.8 %
 
Consolidated net investment income
  $ 10,050       7,064       9,022  
Consolidated realized gain on sale of securities
    528       3,314       2,939  
Consolidated unrealized gain (loss) on trading securities
    2,556       (5,793 )     (5,793 )
 
Total consolidated net investment income
  $ 13,134       4,585       6,168  
 
Consolidated interest expense
  $ 3,394       1,788       1,788  
 
Consolidated income tax expense (benefit)
  $ 2,677       (1,289 )     (1,562 )
 
Consolidated net income (loss)
  $ 9,381       (5,207 )     (3,230 )
 
Three Months Ended March 31, 2006 Compared to Three Months Ended March 31, 2005
Consolidated earned premiums, net and fee revenue for the three months ended March 31, 2006 presented an increase of $48.8 million, or 14.5%, when compared to the consolidated earned premiums, net and fee revenue for the three months ended March 31, 2005. On a comparable basis the consolidated earned premiums, net and fee revenue increased by $36.5 million, or 10.4%. The fluctuation on a comparable basis is attributed to the following:

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    The earned premiums, net and fee revenue corresponding to the Health Insurance — Commercial segment increased by $27.2 million, or 14.4%, during the period. The increase in premiums earned, net of this segment is primarily due to an increase in the average enrollment of the Medicare Advantage business in the 2006 period. The average enrollment of the segment’s rated contracts decreased during the same period, the effect of which was mitigated by an average increase in premium rates of 4.0%.
 
    The earned premiums, net of the Health Insurance — Healthcare Reform segment presented an increase of $4.4 million, or 3.5% during this period. This increase is the result of a 5.8% increase in premium rates effective August 1, 2005, net of decrease in average enrollment.
 
    On a comparable basis, in the 2006 period the earned premiums, net of the Life and Disability Insurance segment increased by $5.5 million, or 34.3%. The increase in the earned premiums net of this segment is due to the following:
  °   The assumed earned premiums of the segment on both the actual and comparable basis increased by $4.4 million in the 2006 period. This increase is due to the business assumed by SVTS during January 2006 as a result of the coinsurance funds withheld agreement with GA Life, in which SVTS assumes 69% of GA Life’s business effective December 22, 2005. However, since TSM acquired GA Life, now both entities form the Corporation’s Life and Disability Insurance segment. Thus, this reinsurance agreement is eliminated upon the combination of both entities for segment presentation. The effects of the reinsurance transactions corresponding to this agreement were eliminated for consolidated financial statement purposes for the period following January 31, 2006.
 
  °   On a comparable basis, the earned premiums of the segment’s individual life and cancer and other dreaded diseases lines of business increased by $714 thousand, or 7.3%, and $639 thousand, or 21.3%, respectively.
Consolidated claims incurred for the three months ended March 31, 2006 increased by $23.8 million, or 7.8%, when compared to the claims incurred for the three months ended March 31, 2005. On a comparable basis, the consolidated claims incurred increased by $17.0 million, or 5.5%. The fluctuation on a comparable basis is mostly due to the increase in the claims incurred of the Health Insurance — Commercial segment during the 2006 period. The claims incurred for this particular segment during the 2006 period presented an increase of $18.0 million, or 10.4%, when compared to the 2005 period. This fluctuation is mostly the result of the segment’s increased volume of business in the Medicare Advantage business.
The consolidated loss ratio reflected a decrease of 5.3 percentage points during the 2006 period. The decrease, on a comparable basis, of the consolidated loss ratio was 4.0 percentage points. This decrease is mostly driven by the Health Insurance — Commercial segment’s growing Medicare Advantage business, which has a lower loss ratio experience as compared to the loss ratio of the other rated contracts business.
Consolidated operating expenses for the three months ended March 31, 2006 increased by $14.0 million, or 31.9%, when compared to the operating expenses for the three months ended March 31, 2005. On a comparable basis, the consolidated operating expenses increased by $8.5 million, or 17.3%. The increase in the consolidated operating expenses on a comparable basis is mainly attributed to the segments increased volume of business during the 2006 period. In addition, the 2006 quarter reflects expenses related to the launching of the new Medicare Advantage policies of the Health Insurance — Commercial segment, Medicare Platino and FarmaMed . The consolidated expense ratio on a comparable basis presented an increased of 0.9 percentage points during the 2006 period.
The consolidated realized gains during the 2006 and 2005 periods are the result of the sound and timely management of the investment portfolio in accordance with corporate investment policies, and from the normal portfolio turnover of the trading and available for sale securities.
The unrealized gain (loss) on trading securities is related to investments held by the segments in equity securities and corporate bonds. The unrealized gain of $2.6 million experienced during the 2006 period is attributed to gains in the portfolios held by the segments in equity securities. One of the equity securities portfolios is designed to replicate the Standard & Poor’s 500 Index and the other two are actively managed

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to simulate the Russell 1000 Growth Index and the Russell 1000 Value Index. All of these indexes experienced positive returns in the 2006 quarter.
The consolidated interest expense presented an increase of $1.6 million on both an actual and comparable basis. This increase is primarily due to the interest expense corresponding to the new debt issued and sold by the Corporation during the last quarter of the year 2005 and during the 2006 period. On December 21, 2005 the Corporation issued and sold its $60.0 million 6.6 % Senior Unsecured Notes Due December 2019 in connection with the coinsurance funds withheld reinsurance agreement with GA Life. On January 23, 2006 the Corporation issued and sold its $35.0 million 6.7% Senior Unsecured Notes Due January 2021 in connection with the acquisition of GA Life. Both Senior Unsecured Notes had the effect of increasing the interest expense of the 2006 period by $1.4 million.
The consolidated income tax expense for the three months period ended March 31, 2006 increased by $4.0 million when compared to the same period of the prior year. The consolidated income tax expense on a comparable basis presented an increase of $4.2 million. This increase is mostly due to an increase in the taxable income when comparing the 2006 to the 2005 periods.
Health Insurance — Commercial Program Operating Results
                 
    Three months ended
    March 31,
(dollar amounts in thousands)   2006   2005
 
Average enrollment:
               
Corporate accounts
    298,626       306,308  
Self-funded employers
    151,970       151,315  
Individual accounts
    77,478       83,290  
Federal employees
    47,966       50,154  
Local government employees
    31,630       36,562  
Medicare Advantage
    18,876       986  
 
Total enrollment
    626,546       628,615  
 
Earned premiums
  $ 211,845       185,057  
Amounts attributable to self-funded arrangements
    51,466       52,234  
Less: Amounts attributable to claims under self-funded arrangements
    (47,377 )     (48,540 )
 
Earned premiums and fee revenue
  $ 215,934       188,751  
 
Claims incurred
  $ 190,857       172,829  
Operating expenses
    28,401       24,240  
 
Total underwriting costs
  $ 219,258       197,069  
 
Underwriting loss
  $ (3,324 )     (8,318 )
 
Loss ratio
    88.4 %     91.6 %
Expense ratio
    13.2 %     12.8 %
 
Combined ratio
    101.5 %     104.4 %
 
Three Months Ended March 31, 2006 Compared to Three Months Ended March 31, 2005
Earned premiums and fee revenue for the three months ended March 31, 2006 increased by $27.2 million, or 14.4%, when compared to the earned premiums and fee revenue for the three months ended March 31, 2005. This increase in earned premiums and fee revenue is the result of the following:
    Premiums generated by the segment’s Medicare Advantage program presented an increase of $28.3 million, from $3.1 million in the 2005 period to $31.4 million in the 2006 period. This increase is primarily due to the increase in enrollment experienced in this business. The average enrollment of the Medicare Advantage program presented an increase of 17,890 members upon

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      comparison of the 2006 and 2005 periods. In January 2006, the segment expanded its Medicare Advantage program with the introduction of Medicare Platino (for medically indigent Medicare-qualified beneficiaries in Puerto Rico) and FarmaMed (prescription drugs program for beneficiaries of Medicare Parts A and B). The enrollment for these programs contributed to the increase in average membership of the Medicare Advantage business.
 
    The segment experienced a decrease in the earned premiums corresponding to its other rated contracts lines of business of approximately $900 thousand. This decrease is the combined effect of a decrease in the average enrollment of 20,614 members, or 4.3% and an average increase in premium rates of 4.0%. The segment maintained its contract renewal ratio of over 90% during the first quarter of 2006. The decrease in average enrollment is primarily noted in the individual and local government employees as a result of qualifying enrollees selecting Medicare Advantage policies. The average enrollment of the individual and local government employees business decreased by 5,812, or 7.0%, and 4,932, or 13.5%, respectively, during the 2006 period.
Claims incurred in the 2006 period presented an increase of $18.0 million, or 10.4%, when compared to the same period in 2005. This increase is mostly related to the claims incurred from the Medicare Advantage business, which presented an increase of $23.5 million during the 2006 period. The increase in the Medicare Advantage claims incurred was offset by a decrease of $5.4 million in the claims incurred in the rated contracts lines of business. The decrease in the claims incurred in the rated contracts lines of business was mostly attributed to the decreased average enrollment of these businesses in the 2006 period, as well as to the result of pharmacy cost containment initiatives implemented during the year 2005. The segment’s loss ratio decreased 3.2 percentage points during 2006 is mainly due to the fact that the loss ratio experience for the growing Medicare Advantage business during this period is lower than the loss ratio of the other rated contracts business and cost containment initiatives.
Operating expenses for the three months ended March 31, 2006 increased by $4.2 million, or 17.2%, when compared to the three months ended March 31, 2005. The segment’s expense ratio increased 0.4 percentage points in the same period. These fluctuations are primarily attributed to advertising and sales costs incurred in 2006 related to the launching of the Medicare Platino and FarmaMed policies, as well as to increases in payroll and related expenses and technology related costs consistent with corporate business initiatives.
Health Insurance — Healthcare Reform Program Operating Results
                 
    Three months ended
    March 31,
(dollar amounts in thousands)   2006   2005
 
Average enrollment:
               
North area
    227,386       232,977  
Metro-north area
    210,887       215,707  
Southwest area
    158,281       162,573  
 
 
    596,554       611,257  
 
Earned premiums
  $ 127,496       123,140  
 
Claims incurred
  $ 113,882       116,088  
Operating expenses
    9,240       8,914  
 
Total underwriting costs
  $ 123,122       125,002  
 
Underwriting income (loss)
  $ 4,374       (1,862 )
 
Loss ratio
    89.3 %     94.3 %
Expense ratio
    7.2 %     7.2 %
 
Combined ratio
    96.6 %     101.5 %
 
Three Months Ended March 31, 2006 Compared to Three Months Ended March 31, 2005

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Earned premiums for the three months ended March 31, 2006 increased by $4.4 million, or 3.5%, when compared to the earned premiums for the same period of last year. This increase is mostly the result of the following:
    Premium rates for this segment were increased, effective August 1 st , 2005, by approximately 5.8% during the Healthcare Reform contract renegotiation process for the eleven-month period ending June 30, 2006.
 
    The segment’s average enrollment during the 2006 quarter decreased by 14,703 members, or 2.4%, when compared to the average enrollment during the 2005 quarter. This decrease is mainly due to the shift of membership into a government-sponsored Medicare Advantage policy ( Medicare Platino ).
Claims incurred during the three months ended March 31, 2006 presented a decrease of $2.2 million, or 1.9%, when compared to the 2005 period. The loss ratio presented a decrease of 5.0 percentage points when comparing the 2006 and 2005 periods. These fluctuations result mostly from the fact that the 2005 period includes an unfavorable development of the reserves of approximately $7.0 million; this unfavorable development is due to higher than expected utilization of services during that period. The loss ratio for the 2005 period, excluding the effect of this unfavorable development of the reserves, is similar to the loss ratio for the 2006 period.
Operating expenses presented an increase of $326 thousand, or 3.7%, when comparing the 2006 and 2005 periods. The expense ratio did not change during the 2006 period. This fluctuation is due to the normal inflationary effect in operational costs.
Property and Casualty Insurance Operating Results
                 
    Three months ended
    March 31,
(dollar amounts in thousands)   2006   2005
 
Premiums written:
               
Commercial multiperil
  $ 13,170       12,984  
Dwelling
    6,190       6,221  
Auto physical damage
    6,010       4,995  
Commercial auto liability
    4,050       3,679  
Other liability
    1,893       2,325  
Medical malpractice
    951       1,101  
All other
    2,469       2,462  
 
Total premiums written
    34,733       33,767  
 
Premiums ceded
    (13,729 )     (14,475 )
Change in unearned premiums
    1,023       2,804  
 
Net premiums earned
  $ 22,027       22,096  
 
Claims incurred
  $ 10,313       11,373  
Operating expenses
    11,642       10,341  
 
Total underwriting costs
  $ 21,955       21,714  
 
Underwriting income
  $ 72       382  
 
Loss ratio
    46.8 %     51.5 %
Expense ratio
    52.9 %     46.8 %
 
Combined ratio
    99.7 %     98.3 %
 
Three Months Ended March 31, 2006 Compared to Three Months Ended March 31, 2005
Total premiums written for the three months period ended March 31, 2006 increased by $966 thousand, or 2.9%, when compared to the three months period ended March 31, 2005. This increase is mostly reflected

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in the premiums written for auto physical damage and commercial auto liability policies, which experienced an increase in premiums of $1.0 million, or 20.3%, and of $371 thousand, or 10.1%, during this period, respectively. The segment is focusing its writings efforts to increase the auto insurance business.
Premiums ceded to reinsurers during the 2006 period presented a decrease of $746 thousand, or 5.2%, when compared to the 2005 period. The ratio of premiums ceded to premiums written reflect a decrease of 3.4 percentage points, from 42.9% in the 2005 period to 39.5% in the 2006 period. This decrease is primarily due to a change in the segment’s transfer of risk to reinsurers. In 2006, the ceding risk transfer percentages for the commercial lines quota share arrangements decreased from 42.5% to 41.0%. The effect of the decrease in the ceding risk transfer percentages for the commercial lines quota share arrangements was mitigated by an increase in the ceding risk transfer percentages for the personal lines quota share arrangements from 10.0% to 13.8%.
Claims incurred reflect a reduction of $1.1 million, or 9.3% when compared to the 2005 period. The loss ratio experienced a decrease of 4.7 percentage points during the 2006 quarter when compared to the same quarter of the prior year. This fluctuation is mostly attributed the segment’s emphasis on quality underwriting which has resulted in better loss experience for this segment, particularly in the commercial multi-peril and auto physical damage lines of business.
The operating expenses for the three months ended March 31, 2006 increased by $1.3 million, or 12.6%, when compared to the operating expenses for the three months ended March 31, 2005. The expense ratio increased by 6.1 percentage points during this period. The increase in operating expenses in the 2006 period is mostly due to an increase in commission expense, payroll and related expenses, and consulting fees. The segment’s commission rates for the commercial multi-peril and commercial auto business in effect in this first quarter of 2006 were 2.5 percentage points higher than those in the 2005 period.
Life and Disability Insurance Operating Results
                         
    Three months ended March 31,
                    Comparable
(dollar amounts in thousands)   2006   2005   Basis 2005
 
Net earned premiums and commission income:
                       
Earned premiums:
                       
Life
  $ 12,543       2,202       12,008  
Disability
    3,182       3,354       3,380  
Cancer and other dreaded diseases
    3,633       213       2,994  
 
Total earned premiums
    19,358       5,769       18,382  
 
Earned premiums ceded
    (2,243 )     (2,023 )     (2,342 )
Assumed earned premiums
    4,413              
 
Net earned premiums
    21,528       3,746       16,040  
 
Commission income on reinsuarance
    153       107       107  
 
Net premiums earned
  $ 21,681       3,853       16,147  
 
Claims incurred
  $ 11,632       2,633       9,351  
Operating expenses
    11,390       1,982       7,437  
 
Total underwriting costs
  $ 23,022       4,615       16,788  
 
Underwriting loss
  $ (1,341 )     (762 )     (641 )
 
Loss ratio
    53.7 %     68.3 %     57.9 %
Expense ratio
    52.5 %     51.4 %     46.1 %
 
Combined ratio
    106.2 %     119.8 %     104.0 %
 
Three Months Ended March 31, 2006 Compared to Three Months Ended March 31, 2005

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Premiums earned for the segment increased by $13.6 million, or 235.6% in the 2006 period. On a comparable basis premiums earned increased by $976 thousand, or 5.3%, mostly as a result of the following fluctuations:
    The premiums earned of the individual life line of business on a comparable basis increased by $714 thousand, or 7.3%, in the 2006 period. This fluctuation is mainly the result of increases in the ordinary life and the monthly debit ordinary (MDO) premiums of 12.0% and 5.0%, respectively. The increase in premiums earned of the ordinary life and MDO business is principally due to new sales made during the 2006 period.
 
    The premiums earned of the cancer and other dreaded diseases on a comparable basis increased by $639 thousand, or 21.3%, in the 2006 period. This increase is primarily attributed to the growth in the sales of the new cancer products that the segment began selling during the last quarter of the year 2004.
 
    The premiums earned on a comparable basis for the group life and group disability lines of business had a combined decrease of $377 thousand, or 6.7%, when compared to the three months ended March 31, 2005. This fluctuation is primarily due to a disciplined underwriting of groups where premiums have been significantly adjusted to reflect expected losses and those groups have decided not to renew.
On December 22, 2005, the segment entered into a coinsurance funds withheld agreement with GA Life. Under the terms of this agreement the segment shares 69% of all the business written by GA Life as of and after the effective date of the agreement. Since GA Life was acquired by TSM effective January 31, 2006, the segment reflects premiums assumed of $4.4 million that represents the segment’s 69% share of premiums for the month of January 2006 under this coinsurance agreement with GA Life. The effects of the reinsurance transactions corresponding to this agreement were eliminated for consolidated financial statement purposes for the period following January 31, 2006.
The claims incurred of the segment increased by $9.0 million, or 341.8%, in the 2006 period. On a comparable basis the claims incurred of the segment increased by $2.3 million, or 24.4%. The increase of the claims incurred on a comparable basis is primarily due to the segment’s 69% share of claims and actuarial reserves for the month of January 2006, under the coinsurance agreement with GA Life amounting to $2.3 million. An increase of $311 thousand, or 4.6%, in the ordinary life claims incurred was offset by a $322 thousand, or 12.2%, decrease in the claims incurred of the group life and disability business. The decrease in the claims incurred of the group life and disability business results from the improved claims experience on these lines, following the terminations during the past three quarters of high loss ratio groups during their renewal process. The segment’s close monitoring of claims experience during each group’s renewal process has resulted in the improvement of the overall loss ratio from 57.9% in the 2005 period (on a comparable basis) to 53.7% in the 2006 period.
The operating expenses increased by $9.4 million, or 474.7% in the 2006 period. On a comparable basis operating expenses presented an increase of $4.0 million, or 53.2%. The expense ratio on a comparable basis presented an increase of 6.4 percentage points. Of the total increase in operating expenses, $1.2 million is related to the segment’s 69% share of commissions and other operating expenses for the month of January 2006, under the coinsurance agreement with GA Life. The remaining increase in operating expenses is mostly related to management fees charged by TSM and increases in commission expense and payroll and related expenses.
Liquidity and Capital Resources
Cash Flows
The Corporation maintains good liquidity measures due to the quality of its assets, the predictability of its liabilities, and the duration of its contracts. The liquidity of the Corporation is primarily derived from the operating cash flows of its insurance subsidiaries.

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As of March 31, 2006 and December 31, 2005, the Corporation’s cash and cash equivalents amounted to $48.9 million and $49.0 million, respectively. The sources of funds available to meet the requirements of the Corporation’s operations include: cash provided from operations, maturities and sales of securities classified within the trading and available-for-sale portfolios, securities sold under repurchase agreements, and issuance of long and short-term debt.
Management believes that the Corporation’s net cash flows from operations are expected to sustain the operations for the next year and thereafter, as long as the operations continue showing positive results. In addition, the Corporation monitors its premium rates and its claims incurred to maintain proper cash flows and has the ability to increase premium rates throughout the year in the monthly renewal process.
Cash Flows from Operations
Most of the cash flows from operating activities are generated from the insurance subsidiaries. The basic components of the cash flows from operations are premium collections, claims payments, payment of operating and acquisition expenses and proceeds from sales and maturities of investments in the trading portfolio.
Net cash flows provided by operating activities amounted to $3.9 million and $27.5 million for the three months ended March 31, 2006 and 2005, respectively, a decrease of $23.6 million. This decrease in cash flows from operating activities is mainly attributed to the net effect of the following:
    The amount of claims, losses and benefits paid for the three months ended March 31, 2006 reflect an increase of $29.1 million when compared with the three months ended March 31, 2005. The increase in the amount of claims, losses and benefits paid is mostly the result of the segments’ increased volume of business.
 
    The payments to suppliers and employees increased by $20.6 million when comparing the amount paid during the 2006 and 2005 periods. This increase is basically attributed to additional commission expense generated from the acquisition of new business and general operating expenses.
 
    The net proceeds of investments in the trading portfolio decreased by $17.3 million for the three months ended March 31, 2006, when compared to the three months ended March 31, 2005. The fluctuation when compared to the 2005 period is due to the sale of the corporate bonds portfolio in mid year 2005. The corporate bonds portfolio was considered as a trading portfolio.
 
    Premiums collected increased by $42.8 million when comparing collections during the three months ended March 31, 2006 with collections for the three months ended March 31, 2004. This increase is mostly related to the increased volume of business and increases in premium rates of the operating segments.
 
    Interest received increased by $4.1 million during the 2006 period. This increase is mostly the related to the increase experienced in the Corporations investments in fixed income securities during the 2006 period.
Any excess liquidity is available, among other things, to invest in high quality and diversified fixed income securities and, to a lesser degree, to invest in marketable equity securities.
Cash Flows from Investing Activities
The basic components of the cash flows from investing activities are derived from acquisitions and proceeds from sales and maturities of investments in the available-for-sale and held-to-maturity portfolios and capital expenditures. The Corporation monitors the duration of its investment portfolio and executes the purchases and sales of these investments with the objective of having adequate funds available to satisfy its maturing liabilities.
Net cash flows used in investing activities amounted to $33.6 million and $14.9 million for the three months ended March 31, 2006 and 2005, respectively, an increase of $18.7 million. The increase in the cash flows used in investing activities during this period is attributed to the following:

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    During the 2006 period the Corporation completed the acquisition of 100% of the common stock of GA Life. This transaction had an acquisition cost of $38.2 million, net of $10.4 million of acquired cash.
 
    The amount of capital expenditures increased by $2.4 million when comparing the 2006 and 2005 periods. This increase is principally due to incurred cost related to the renovation of one of Corporation’s facilities in one building adjacent to its main offices and to expenses related to STS’s acquisition of a new computer system to manage its insurance operations.
 
    The Corporation had net decrease of $11.6 million in the net acquisition of investments during the 2006 period. During the three months ended March 31, 2006 and 2005 total acquisition of investments exceeded the proceeds from investments sold or matured by $1.9 million and $13.5 million, respectively.
Cash Flows from Financing Activities
Net cash flows provided by financing activities amounted to $29.6 million and $10.4 million for the three months ended March 31, 2006 and 2005, respectively. The increase of $19.2 million when compared to the same period of the prior year is mainly due to the effect of following fluctuations:
    During the three months ended March 31, 2006 the Corporation received the proceeds from the issuance of its 6.7% Senior Unsecured Notes amounting to $35.0 million. No long-term debt was issued in the 2005 period.
 
    On January 13, 2006 the Corporation declared and paid dividends amounting to $6.2 million. There was no dividend payment during the 2005 period.
 
    The change in outstanding checks in excess of bank balances reflects a decrease of $6.1 million during the three months ended March 31, 2006 compared to the 2005 period. The amount of checks in excess of bank balances represents a timing difference between the issuance of checks and the cash balance in the bank account at one point in time.
 
    In the 2006 period the payments of short-term borrowings exceeded proceeds from short-term borrowings by $1.7 million. In the 2005 period the short-term borrowings activity did not result in net borrowings or payments. Short-term borrowings are used to address timing differences between cash receipts and disbursements.
Financing and Financing Capacity
The Corporation has significant short-term liquidity supporting its businesses. It also has available short-term borrowings from time to time to address timing differences between cash receipts and disbursements. These short-term borrowings are mostly in the form of securities sold under repurchase agreements. As of March 31, 2006, the Corporation had $227.5 million in available credit on these agreements. There are no outstanding short-term borrowings as of March 31, 2006.
As of March 31, 2006 the Corporation has the following senior unsecured notes payable:
    On September 30, 2004 TSI issued and sold $50.0 million of its 6.3% senior unsecured notes due September 2019 (the 6.3% notes). The 6.3% notes are unconditionally guaranteed as to payment of principal, premium, if any and interest by the Corporation. The notes were privately placed to various institutional accredited investors. The notes pay interest semiannually beginning on March 2005, until such principal becomes due and payable. These notes can be prepaid after five years at par, in total or partially, as determined by the Corporation. Most of the proceeds obtained from this issuance were used to repay $37.0 million of short-term borrowings made by TSI. The remaining proceeds were used for general business purposes.
 
    On December 21, 2005 TSM issued and sold $60.0 million of its 6.6% senior unsecured notes due December 2020 (the 6.6% notes). The 6.6% notes were privately placed to various institutional accredited investors. The notes pay interest each month beginning on January 2006, until such principal becomes due and payable. These notes can be prepaid after five years at par, in full or in

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      part, as determined by the Corporation. The proceeds obtained from this issuance were used to pay the initial ceding commission to GA Life on the effective date of the coinsurance funds withheld reinsurance agreement.
Both the 6.3% and the 6.6% notes contain certain covenants with which TSI and the Corporation have complied with at March 31, 2006.
On January 23, 2006 the Corporation issued and sold $35.0 million of its 6.7% senior unsecured notes payable due January 2021 (the 6.7% notes). The 6.7% notes were privately placed to various accredited institutional investors. The notes pay interest each month beginning on March 1, 2006, until such principal becomes due and payable. These notes can be prepaid after five years at par, in full or in part, as determined by the Corporation. The proceeds obtained from this issuance were used to finance the acquisition of 100% of the common stock of GA Life effective January 31, 2006.
In addition, the Corporation has two credit agreements with a commercial bank, FirstBank Puerto Rico. These credit agreements bear interest rates based on the London Interbank Offered Rate (LIBOR) plus a margin specified by the commercial bank at the time of the agreement. As of March 31, 2006, the two credit agreements have an outstanding balance of $28.8 million and $11.5 million, respectively. These credit agreements contain restrictive covenants, including, but not limited to, the granting of certain liens, limitations on acquisitions and limitations on changes in control. As of March 31, 2006, management believes the Corporation is in compliance with these covenants.
Further details regarding the senior unsecured notes and the credit agreements are incorporated by reference to Item 2. “Management’s Discussion and Analysis of Financial Condition and Results of Operations” of the Corporation’s Annual Report on Form 10-K as of and for the year ended December 31, 2005.
Item 3. Quantitative and Qualitative Disclosures about Market Risk
The Corporation is exposed to certain market risks that are inherent in the Corporation’s financial instruments, which arise from transactions entered into in the normal course of business. The Corporation has exposure to market risk mostly in its investment activities. For purposes of this disclosure, “market risk” is defined as the risk of loss resulting from changes in interest rates and equity prices. No material changes have occurred in the Corporation’s exposure to financial market risks since December 31, 2005. A discussion of the Corporation’s market risk as of December 31, 2005 is incorporated by reference to Item 7A “Quantitative and Qualitative Disclosures about Market Risk” of the Corporation’s Annual Report on Form 10-K.
Item 4. Controls and Procedures
The Corporation’s management, with the participation of the Chief Executive Officer and Chief Financial Officer, has evaluated the effectiveness of the Corporation’s disclosure controls and procedures as of March 31, 2006. Based on that evaluation, the Corporation’s Chief Executive Officer and Chief Financial Officer concluded that the Corporation’s disclosure controls and procedures were effective as of March 31, 2006. There were no significant changes in the Corporation’s disclosure controls and procedures, or in factors that could significantly affect internal controls, subsequent to the date the Chief Executive Officer and Chief Financial Officer completed the evaluation referred to above.
Part II — Other Information
Item 1. Legal Proceedings
(a)   As of March 31, 2006, the Corporation is a defendant in various lawsuits arising out of the ordinary course of business. Management believes, based on the opinion of legal counsel, that the aggregate liabilities, if any, arising from such actions would not have a material adverse effect on the Corporation’s consolidated financial position or results of operations.

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(b)   Drs. Carlyle Benavent and Ibrahim Pérez (the plaintiffs) caused the initiation of an administrative proceeding before the Puerto Rico Insurance Commissioner against TSI and TSM alleging the illegality of the repurchase and subsequent sale of 1,582 shares of TSI’s common stock due to the fact that the ultimate purchasers of said shares were selected on an improper and selective basis by the Corporation in violation of the Puerto Rico Insurance Code. The plaintiffs alleged that they were illegally excluded from participation in the sale of shares by TSI due to the illegally selective nature of the sale of shares and that, consequently, the sale of shares should be eliminated.
 
    In December 1996, the Commissioner of Insurance issued an order to annul the sale of the 1,582 shares that TSI had repurchased from the estate of deceased stockholders. TSI contested such order through an administrative and judicial review process. Consequently, the sale of 1,582 shares was cancelled and the purchase price was returned to each former stockholder. In the year 2000, the Commissioner of Insurance issued a pronouncement providing further clarification of the content and effect of the order. This order also required that all corporate decisions undertaken by TSI through the vote of its stockholders of record, be ratified in a stockholders’ meeting or in a subsequent referendum. In November 2000, TSM, as the sole stockholder of TSI, ratified all such decisions. Furthermore, on November 19, 2000, TSM held a special stockholders’ meeting, where a ratification of these decisions was undertaken except for the resolution related to the approval of the reorganization of TSI and its subsidiaries. This resolution did not reach the two thirds majority required by the order because the number of shares that were present and represented at the meeting was below such amount (total shares present and represented in the stockholders’ meeting was 64%). As stipulated in the order, TSM began the process to conduct a referendum among its stockholders in order to ratify such resolution. The process was later suspended because upon further review of the scope of the order, the Commissioner of Insurance issued an opinion in a letter dated January 8, 2002 which indicated that the ratification of the corporate reorganization was not required.
 
    In another letter dated March 14, 2002, the Commissioner of Insurance stated that the ratification of the corporate reorganization was not required and that TSI had complied with the Commissioner’s order of December 6, 1996 related to the corporate reorganization. Thereafter, the plaintiffs filed a petition for review of the Commissioner’s determination before the Puerto Rico Circuit Court of Appeals. Such petition was opposed by TSI and by the Commissioner of Insurance.
 
    Pursuant to that review, on September 24, 2002, the Puerto Rico Circuit Court of Appeals issued an order requiring the Commissioner of Insurance to order that a meeting of shareholders be held to ratify TSI’s corporate reorganization and the change of name of TSI from Seguros de Servicios de Salud de Puerto Rico, Inc. to Triple-S, Inc. The Puerto Rico Circuit Court of Appeals based its decision on administrative and procedural issues directed at the Commissioner of Insurance. The Commissioner of Insurance filed a motion of reconsideration with the Puerto Rico Circuit Court of Appeals on October 11, 2002. TSM and TSI also filed a motion of reconsideration.
 
    On October 25, 2002, the Puerto Rico Circuit Court of Appeals dismissed the Commissioner of Insurance’s Motion for Reconsideration and ordered the plaintiffs to reply to TSI’s Motion of Reconsideration.
 
    On May 18, 2003, the Puerto Rico Circuit Court of Appeals granted TSI’s and TSM’s Motion of Reconsideration. The Puerto Rico Circuit Court of Appeals held that the Commissioner of Insurance had the authority to waive the celebration of a referendum to ratify TSI’s reorganization and that therefore the reorganization of TSI, inasmuch as the 1,582 shares annulled were not decisive, was approved by the stockholders.
 
    On June 26, 2003, the plaintiffs presented a writ of certiorari before the Supreme Court of Puerto Rico. TSI and TSM filed a motion opposing the issuance of the writ. The writ was issued by the Supreme Court on August 22, 2003 when it ordered the Puerto Rico Circuit Court of Appeals to transmit the record of the case. On December 1, 2003, the plaintiffs filed a motion submitting their case on the basis of their original petition. TSI and TSM filed its brief on December 30, 2003, while the Commissioner of Insurance, in turn, filed a separate brief on December 31, 2003. On June 24, 2004

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    the Supreme Court of Puerto Rico ordered the plaintiffs to file a brief in support of their allegations. The case is still pending before the Supreme Court of Puerto Rico. It is the opinion of the management and its legal counsels that the corporate reorganization as approved is in full force and effect.
(c)   On September 4, 2003, José Sánchez and others filed a putative class action complaint against the Corporation, present and former directors of TSM and TSI, and others, in the United States District Court for the District of Puerto Rico, alleging violations under the Racketeer Influenced and Corrupt Organizations Act, better known as the RICO Act. The suit, among other allegations, alleges a scheme to defraud the plaintiffs by acquiring control of TSI through illegally capitalizing TSI and later converting it to a for-profit corporation and depriving the stockholders of their ownership rights. The plaintiffs base their later allegations on the supposed decisions of TSI’s board of directors and stockholders, allegedly made in 1979, to operate with certain restrictions in order to turn TSI into a charitable corporation, basically forever. On March 4, 2005 the Court issued an Opinion and Order. In this Opinion and Order, of the twelve counts included in the complaint, eight counts were dismissed for failing to assert an actionable injury; six of them for lack of standing and two for failing to plead with sufficient particularity in compliance with the Rules. All shareholder allegations, including those described above, were dismissed in the Opinion and Order. The remaining four counts were found standing, in a limited way, in the Opinion and Order. The parties finished class certification discovery and fully briefed the issue of class certification. While waiting for the Court’s decision on the issue of class certification, the Court, sua sponte , issued an Order to Show Cause (OTC) to plaintiffs as to why the complaint should not be dismissed with prejudice. The Court’s OTC is predicated on the parties’ submissions about class certification. The Court then granted plaintiffs leave to file a sur-reply, which they did on April 21, 2006. In its OTC the Court indicated that it will decide first the sustainability of the complaint before deciding plaintiffs’ request for class certification. The parties are in anticipation of the Court’s ruling on the OTC. On May 4, 2006, the Court issued an Opinion and Order which entered a summary judgment in favor of the Corporation and the case was dismissed by the Court. The plaintiffs have ten (10) business days to file for reconsideration with the Court, they may also request additional findings from the Court, and/or they have thirty (30) days to appeal the judgment to the United States Court of Appeals for the First Circuit.
(d)   On April 24, 2002, Octavio Jordán, Agripino Lugo, Ramón Vidal, and others filed a suit against TSM, TSI and others in the Court of First Instance for San Juan, Superior Section, alleging, among other things, violations by the defendants of provisions of the Puerto Rico Insurance Code, anti-monopolistic practices, unfair business practices and damages in the amount of $12.0 million. They also requested that TSM sell shares to them. After a preliminary review of the complaint, it appears that many of the allegations brought by the plaintiffs have been resolved in favor of TSM and TSI in previous cases brought by the same plaintiffs in the United States District Court for the District of Puerto Rico and by most of the plaintiffs in the local courts. The defendants, including TSM and TSI answered the complaint, filed a counterclaim and filed several motions to dismiss this claim. On February 18, 2005 the plaintiffs informed their intention to amend the complaint and the Court granted them 45 days to do so and 90 days to the defendants to file the corresponding motion to dismiss. On May 9, 2005 the plaintiffs amended the complaint and the defendants are preparing the corresponding motions to dismiss this amended complaint. The plaintiffs amended the complaint to allege causes of action similar to those dismissed by the United States District Court for the District of Puerto Rico in the Sánchez case. Defendants moved to dismiss the amended complaint. Plaintiffs have notified their opposition to some of the defendants’ motion to dismiss, and the defendants filed the corresponding replies. On January 25, 2006, the court held a hearing to argue the dispositive motions. On March 16, 2006 the Court held another hearing to hear additional argument on the same motions. The Court set a final hearing for July 6, 2006.
(e)   On May 22, 2003 a putative class action suit was filed by Kenneth A. Thomas, M.D. and Michael Kutell, M.D., on behalf of themselves and all others similarly situated and the Connecticut State Medical Society against the Blue Cross and Blue Shield Association (BCBSA) and multiple other insurance companies including TSI. The case is pending before the U.S. District Court for the Southern District of Florida, Miami District.

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    The individual plaintiffs bring this action on behalf of themselves and a class of similarly situated physicians seeking redress for alleged illegal acts of the defendants, which they allege have resulted in a loss of their property and a detriment to their business, and for declaratory and injunctive relief to end those practices and prevent further losses. Plaintiffs alleged that the defendants, on their own and as part of a common scheme, systematically deny, delay and diminish the payments due to doctors so that they are not paid in a timely manner for the covered, medically necessary services they render.
 
    The class action complaint alleges that the health care plans are the agents of BCBSA licensed entities, and as such have committed the acts alleged above and acted within the scope of their agency, with the consent, permission, authorization and knowledge of the others, and in furtherance of both their interest and the interests of other defendants.
 
    Management believes that TSI was brought to this litigation for the sole reason of being associated with the BCBSA. However, on June 18, 2004 the plaintiffs moved to amend the complaint to include the Colegio de Médicos y Cirujanos de Puerto Rico (a compulsory association grouping all physicians in Puerto Rico), Marissel Velázquez, MD, President of the Colegio de Médicos y Cirujanos de Puerto Rico, and Andrés Meléndez, MD, as plaintiffs against TSI. Later Marissel Velázquez, MD voluntarily dismissed her complaint against TSI.
 
    TSI, along with the other defendants, moved to dismiss the complaint on multiple grounds, including but not limited to arbitration and applicability of the McCarran Ferguson Act.
 
    The Court issued a 90-day stay to allow the parties to discuss their differences and come to amicable agreement. The stay expired on March 7, 2006. Upon the expiration of the stay, both plaintiffs and defendants agreed to request the Court to extend the stay until April 21, 2006. The stay expired and the parties informed the Court that they need additional time to iron out the details of an amicable solution. The Court has not reacted to the parties’ joint request. If the Court denies another stay, the parties will have to continue the proceedings where they were left before the issuance of the first stay. In the meantime, the Court issued an Agreed Order on the Preservation of Records. This order supersedes the parties’ existing record-keeping policies in regards to the documents and materials specified in the order. The purpose of the order is to avoid the disposition of documents that might be relevant for the case.
(f)   On December 8, 2003 a putative class action was filed by Jeffrey Solomon, MD and Orlando Armstrong, MD, on behalf of themselves and all other similarly situated and the American Podiatric Medical Association, Florida Chiropractic Association, California Podiatric Medical Association, Florida Podiatric Medical Association, Texas Podiatric Medical Association, and Independent Chiropractic Physicians, against the BCBSA and multiple other insurance companies, including TSI and all members of the BCBSA. The case is still pending before the United States District Court for the Southern District of Florida, Miami District.
 
    The lawsuit challenges many of the same practices as the litigation described in the immediately preceding item.
 
    Management believes that TSI was made a party to this litigation for the sole reason that TSI is associated with the BCBSA.
 
    On June 25, 2004, plaintiffs amended the complaint but the allegations against TSI did not vary. TSI along with the other defendants, moved to dismiss the complaint on multiple grounds, including but not limited to arbitration and applicability of the McCarran Ferguson Act.
 
    The Court issued a 90-day stay to allow the parties to discuss their differences and come to an amicable agreement. The stay expired on March 7, 2006. Upon the expiration of the stay, both plaintiffs and defendants agreed to request the Court to extend the stay until April 21, 2006. The stay expired and the parties informed the Court that they need additional time to iron out the details of an amicable solution. The Court has not reacted to the parties’ joint request. If the Court denies another

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    stay, the parties will have to continue the proceedings where they were left before the issuance of the first stay. In the meantime, the Court issued an Agreed Order on the Preservation of Records. This order supersedes the parties’ existing record-keeping policies in regards to the documents and materials specified in the order. The purpose of the order is to avoid the disposition of documents that might be relevant for the case.
Item IA. Risk Factors
Other than as disclosed in Item 2 “Management’s Discussion and Analysis of Financial Condition and Results of Operations” in the section “Recent Developments — Puerto Rico’s Economy”, no material change has occurred from risk factors previously disclosed by the Corporation in its Annual Report on Form 10-K for December 31. 2005.
Item 2. Unregistered Sales of Equity Securities and Use of Proceeds
Not applicable.
Item 3. Defaults Upon Senior Securities
Not applicable.
Item 4. Submissions of Matters to a Vote of Security Holders
On February 5, 2006, the Corporation held the continuation of its Seventh Annual Meeting of Shareholders (the “Meeting”), which commenced on April 24, 2005. During the meeting, shareholders had to vote on four resolutions that were presented by the Board of Directors and a shareholder.
Resolution Number 3 was presented by the Board of Directors of the Corporation to amend Article Eighth of the Articles of Incorporation and Articles 4-2 and 4-3 of the Bylaws to allow the transfer of shares to any physician or dentist of one or more common shares during his/her lifetime or upon his/her death, if no kind of payment, service, obligation, or other inducement had been or was to be provided or rendered, and if said physician or dentist complied with the Articles of Incorporation limit requirement of twenty-one (21) common shares. This resolution required the affirmative vote of two-thirds (2/3) or more of the issued and outstanding common shares with the right to vote for its approval.
The voting results for Resolution Number 3 were the following: 6,014 of the issued and outstanding common shares with the right to vote of the Corporation exercised their right to vote either in person or by proxy at the Meeting; 4,927 (81.9%) voted to approve the Resolution; 864 (14.4%) voted not to approve the Resolution; 203 (3.4%) shares abstained from voting; and, 20 (0.3%) voted in blank. This Resolution was not approved since it required the affirmative vote of two-thirds (2/3) or more of the issued and outstanding common shares with the right to vote for its approval, which would have been 5,936 shares.
Resolution Number 4 was presented by the Board of Directors of the Corporation to amend and renumber Articles Fourth, Fifth, Sixth, Seventh, Eighth, Ninth, Tenth, Eleventh, Twelfth, and Thirteenth of the Articles of Incorporation to establish that the authorized capital of the Corporation would be divided into two classes of common shares: (1) Voting Common Shares, which would have been the common shares authorized by the Corporation since its establishment, in other words, the existing common shares, and (2) Non-Voting Common Shares, which would have not been available for purchase, since they would only be issued so that one or more of the voting common shares of a shareholder could have been exchanged, upon his/her death, for an equal amount of non-voting common shares for the benefit of his/her heirs or surviving spouse when they were not physicians or dentists, subject to, among other requirements to be complied with, the twenty-one (21) common shares per person limit. In addition, this Resolution included revisions of some provisions in order to improve or correct the text or language of the Articles of Incorporation. This resolution required three-fourths (3/4) or more of the issued and outstanding common shares with the right to vote for its approval.
The voting results for Resolution Number 4 were the following: 6,028 of the issued and outstanding common shares with the right to vote of the Corporation exercised their right to vote either in person or by

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proxy at the Meeting; 5,053 (83.8%) voted to approve the Resolution; and, 803 (13.3%) voted not to approve the Resolution; 172 (2.9%) shares abstained from voting. This Resolution was not approved since it required the affirmative vote of three-fourths (3/4) or more of the issued and outstanding common shares with the right to vote for its approval, which would have been 6,678 shares.
Resolution Number 5 was presented by the Board of Directors of the Corporation to amend Chapters 1, 2, 3, 4, 5, 6, 7, 8, 9, and 10 of the By-laws of the Corporation to establish that the authorized capital of Triple-S Management Corporation would be divided into two classes of common shares: (1) Voting Common Shares, which would have been the common shares authorized by the Corporation since its establishment, in other words, the existing common shares, and (2) Non-Voting Common Shares, which would have not been available for purchase, since they would only be issued so that one or more of the voting common shares of a shareholder could have been exchanged, upon his/her death, for an equal amount of non-voting common shares for the benefit of his/her heirs or surviving spouse when they were not physicians or dentists, subject to, among other requirements to be complied with, the twenty-one (21) common shares per person limit. In addition, this Resolution included the revisions of some provisions in order to improve or correct the text or language of the By-laws. This resolution required three-fourths (3/4) or more of the issued and outstanding common shares with the right to vote for its approval.
The voting results for Resolution Number 5 were the following: 6,010 of the issued and outstanding common shares with the right to vote of the Corporation exercised their right to vote either in person or by proxy at the Meeting; 5,136 (85.5%) voted to approve the Resolution; 727 (12.1%) voted not to approve the Resolution; and, 147 (2.4%) shares abstained from voting. This Resolution was not approved since it required the affirmative vote of three-fourths (3/4) or more of the issued and outstanding common shares with the right to vote for its approval, which would have been 6,678 shares.
Resolution Number 6 was presented by Leslie H. López Vélez, DDS, shareholder of the Corporation, to amend Articles Sixth, Seventh, and Thirteenth of the Articles of Incorporation and Articles 4-1 and 9-1 of the Bylaws of Triple-S Management Corporation in order to reduce from three-fourths (3/4) to two-thirds (2/3) the amount of issued and outstanding common shares with the right to vote required to approve certain amendments to Article Sixth of the Articles of Incorporation and Article 4-1 of the Bylaws. This resolution required three-fourths (3/4) or more of the issued and outstanding common shares with the right to vote for its approval.
The voting results for Resolution Number 6 were the following: 6,004 of the issued and outstanding common shares with the right to vote of the Corporation exercised their right to vote either in person or by proxy at the Meeting; 4,737 (78.9%) voted to approve the Resolution; 1,072 (17.9%) voted not to approve the Resolution; 189 (3.1%) shares abstained from voting; and, 6 (0.1%) voted in blank. This Resolution was not approved since it required the affirmative vote of three-fourths (3/4) or more of the issued and outstanding common shares with the right to vote for its approval, which would have been 6,678 shares.
Item 5. Other Information
Not applicable.
Item 6. Exhibits
(a) Exhibits:
Exhibit 10.1 6.70% Senior Unsecured Notes Due January 2021 Note Purchase Agreement, dated January 23, 2006, between Triple-S Management Corporation and various institutional accredited investors.
Exhibit 11 Statement re computation of per share earnings; an exhibit describing the computation of the earnings per share for the three months ended March 31, 2006 and 2005 has been omitted as the detail necessary to determine the computation of earnings per share can be clearly determined from the material contained in Part I of this Quarterly Report on Form 10-Q.
Exhibit 12 Statements re computation of ratios; an exhibit describing the computation of the loss ratio, expense ratio and combined ratio for the three months ended March 31, 2006 and 2005 has been

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omitted as the detail necessary to determine the computation of the loss ratio, expense ratio and combined ratio can be clearly determined from the material contained in Part I of this Quarterly Report on Form 10-Q.
Exhibit 31.1 Certification of the President and Chief Executive Officer required by Rule 13a-14(a)/15d-14(a).
Exhibit 31.2 Certification of the Vice President of Finance and Chief Financial Officer required by Rule 13a-14(a)/15d-14(a).
Exhibit 32.1 Certification of the President and Chief Executive Officer required pursuant to 18 U.S.C Section 1350.
Exhibit 32.2 Certification of the Vice President of Finance and Chief Financial Officer required pursuant to 18 U.S.C Section 1350.
All other exhibits for which provision is made in the applicable accounting regulation of the United States Securities and Exchange Commission are not required under the related instructions or are inapplicable, and therefore have been omitted.
SIGNATURES
Pursuant to the requirements of the United States Securities and Exchange Act of 1934, the registrant has duly caused this report to be signed on its behalf by the undersigned thereunto duly authorized.
                 
 
               
        Triple-S Management Corporation    
        Registrant    
 
               
Date: May 12, 2006
      By:   /s/ Ramón M. Ruiz-Comas    
 
               
 
          Ramón M. Ruiz-Comas, CPA    
 
          President and    
 
          Chief Executive Officer    
 
               
Date: May 12, 2006
      By:   /s/ Juan J. Román    
 
               
 
          Juan J. Román, CPA    
 
          Vice President of Finance    
 
          and Chief Financial Office    

44


TRIPLE-S MANAGEMENT CORPORATION

US$35,000,000

6.70% Senior Unsecured Notes due January 2021


NOTE PURCHASE AGREEMENT


Dated January 23, 2006



TABLE OF CONTENTS

Section                                                                     Page
-------                                                                     ----
1.  AUTHORIZATION OF NOTES...............................................     1

2.  SALE AND PURCHASE OF NOTES...........................................     1

3.  CLOSING..............................................................     1

4.  CONDITIONS TO CLOSING................................................     2
    4.1.  Representations and Warranties.................................     2
    4.2.  Performance; No Default........................................     2
    4.3.  Compliance Certificates and Organizational Documents...........     2
    4.4.  Opinions of Counsel............................................     3
    4.5.  Purchase Permitted by Applicable Law, etc......................     3
    4.6.  Private Placement Number.......................................     3
    4.7.  Changes in Corporate Structure.................................     3
    4.8.  Proceedings and Documents......................................     3

5.  REPRESENTATIONS AND WARRANTIES OF THE COMPANY........................     3
    5.1.  Organization; Power and Authority..............................     3
    5.2.  Authorization, etc.............................................     4
    5.3.  Financial Statements...........................................     4
    5.4.  Compliance with Laws, Other Instruments, etc...................     5
    5.5.  Governmental Authorizations, etc...............................     5
    5.6.  Litigation; Observance of Statutes and Orders..................     5
    5.7.  Taxes..........................................................     6
    5.8.  Title to Property; Leases......................................     6
    5.9.  Licenses, Permits, etc.........................................     6
    5.10. Compliance with ERISA..........................................     6
    5.11. Private Offering by the Company................................     7
    5.12. Use of Proceeds................................................     7
    5.13. Existing Indebtedness for Borrowed Money.......................     7
    5.14. Investment Company Act.........................................     8
    5.15. Disclosure.....................................................     8
    5.16. Labor Disputes.................................................     8
    5.17. Source of Income...............................................     8

6.  REPRESENTATIONS OF THE PURCHASER.....................................     8
    6.1.  Purchase for Investment; Accredited Investor...................     8
    6.2.  Source of Funds................................................     9
    6.3.  Anti-Money Laundering..........................................    10
    6.4.  Transferee.....................................................    11

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7.  INFORMATION AS TO THE COMPANY........................................    11
    7.1.  Financial and Business Information.............................    11
    7.2.  Inspection.....................................................    12

8.  PAYMENT OF INTEREST..................................................    13

9.  REDEMPTION OF THE NOTES PRIOR TO MATURITY............................    13
    9.1.  Optional Redemption............................................    13
    9.2.  Allocation of Partial Redemptions..............................    13
    9.3.  Maturity; Surrender, etc.......................................    14
    9.4.  Purchase of Notes..............................................    14

10. BUSINESS COVENANTS...................................................    14
    10.1. Compliance with Laws...........................................    14
    10.2. Insurance......................................................    14
    10.3. Payment of Taxes...............................................    15
    10.4. Use of Proceeds................................................    15
    10.5. Corporate Existence, etc.......................................    15
    10.6. Source of Income...............................................    15
    10.7. Lines of Business..............................................    15

11. NEGATIVE COVENANTS...................................................    16
    11.1. Transactions with Affiliates...................................    16
    11.2. Consolidation, Merger and Sale of Assets.......................    16
    11.3. Limitation Upon Creation of Liens on Voting Stock of
          Significant Subsidiaries.......................................    16
    11.4. Limitation Upon Disposition of Voting Stock of, and Merger and
          Sale of Assets of, Principal Insurance Subsidiary..............    17
    11.5. Limitation on Dividends and Other Payment Restrictions
          Affecting Subsidiaries.........................................    18
    11.6. Limitation on Additional Indebtedness..........................    19
    11.7. Waiver of Certain Covenants....................................    19

12. EVENTS OF DEFAULT....................................................    19

13. REMEDIES ON DEFAULT, ETC.............................................    21
    13.1. Acceleration...................................................    21
    13.2. Other Remedies.................................................    21
    13.3. Rescission.....................................................    21
    13.4. No Waivers or Election of Remedies, Expenses, etc..............    22

14. REGISTRATION; EXCHANGE; SUBSTITUTION OF NOTES........................    22
    14.1. Registration of Notes..........................................    22
    14.2. Transfer and Exchange of Notes.................................    22
    14.3. Replacement of Notes...........................................    23

15. PAYMENTS ON NOTES....................................................    23
    15.1. Place of Payment...............................................    23

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    15.2. Home Office Payment............................................    23

16. SURVIVAL OF REPRESENTATIONS AND WARRANTIES; ENTIRE AGREEMENT.........    24

17. AMENDMENT AND WAIVER.................................................    24
    17.1. Requirements...................................................    24
    17.2. Solicitation of Holders of Notes...............................    25
    17.3. Binding Effect, etc............................................    25
    17.4. Notes held by Company, etc.....................................    25
    17.5. Consent of Majority Holders....................................    25

18. NOTICES..............................................................    26

19. REPRODUCTION OF DOCUMENTS............................................    26

20. CONFIDENTIAL INFORMATION.............................................    26

21. MISCELLANEOUS........................................................    27
    21.1. Successors and Assigns.........................................    27
    21.2. Payments Due on Non-Business Days..............................    28
    21.3. Severability...................................................    28
    21.4. Construction...................................................    28
    21.5. Counterparts...................................................    28
    21.6. Governing Law..................................................    28

SCHEDULE A    -- INFORMATION RELATING TO PURCHASER

SCHEDULE B    -- DEFINED TERMS

SCHEDULE 5.3  -- Financial Statements of the Company

SCHEDULE 5.6  -  Litigation

SCHEDULE 5.13 -- Existing Indebtedness for Borrowed Money

EXHIBIT 1     -- Form of 6.70% Senior Unsecured Notes due January 2021

EXHIBIT 2-A   -- Form of Opinion of Pietrantoni Mendez & Alvarez LLP

EXHIBIT 2-B   -- Form of Opinion of Enrique R. Ubarri Baragano

iii

TRIPLE-S MANAGEMENT CORPORATION

6.70% Senior Unsecured Notes due January 2021

January 23, 2006

THE PURCHASERS NAMED IN
THE ATTACHED SCHEDULE A:

Ladies and Gentlemen:

Triple-S Management Corporation (the "COMPANY"), a corporation organized under the laws of the Commonwealth of Puerto Rico, agrees with you as follows:

1. AUTHORIZATION OF NOTES.

The Company has authorized the issuance and sale of an aggregate principal amount of Thirty-Five Million United States Dollars (US$35,000,000) of its 6.70% Senior Unsecured Notes due January 2021 (the "NOTES," such term to include each Note delivered pursuant to this Agreement and each Note delivered in substitution or exchange for any such Note pursuant to Section 14 of this Agreement). The Notes shall be substantially in the form of Exhibit 1 hereto and shall have the terms as herein and therein provided. Certain capitalized terms used in this Agreement are defined in Schedule B hereto; references to a "SCHEDULE" or an "EXHIBIT" are, unless otherwise specified, to a Schedule or an Exhibit attached to this Agreement and all Schedules and Exhibits are deemed to be a part of this Agreement. References herein to this "AGREEMENT" mean this Agreement as from time to time amended or supplemented or as the terms hereof may be waived, in accordance with Section 17 hereof.

2. SALE AND PURCHASE OF NOTES.

Subject to the terms and conditions of this Agreement, the Company agrees to issue and sell to you and you agree to purchase from the Company, at the Closing provided for in Section 3, Notes in the aggregate principal amount specified opposite your name in Schedule A at the purchase price of one hundred percent (100%) of the principal amount thereof.

3. CLOSING.

The closing (the "CLOSING") of the sale and purchase of the Notes to be purchased by you shall occur at the offices of Pietrantoni Mendez & Alvarez LLP, Popular Center Building, 209 Munoz Rivera Avenue, 19th Floor, San Juan, Puerto Rico 00918, at 10:00 a.m., local time, on January 31, 2006. At the Closing, the Company will deliver to you the Notes to be purchased by you in the form of a single Note for each Purchaser (or such greater number of Notes in denominations of at least Five Hundred Thousand United States Dollars (US$500,000) as you may request) dated the date of the Closing (the "CLOSING DATE") and registered in your name (or in the name of your nominee), against delivery by you to the Company of immediately available


funds in the amount of the purchase price therefor by wire transfer to account number 10991506, maintained by the Company at Citibank, N.A., Puerto Rico Branch, ABA Number 02100089.

4. CONDITIONS TO CLOSING.

Your obligation to purchase and pay for the Notes to be delivered to you at the Closing is subject to the fulfillment, prior to or at the Closing, of the following conditions:

4.1. REPRESENTATIONS AND WARRANTIES.

The representations and warranties of the Company contained in Section 5 of this Agreement shall have been true and correct in all material respects as of the date of this Agreement and shall be true and correct at the time of the Closing.

4.2. PERFORMANCE; NO DEFAULT.

The Company shall have performed and complied in all material respects with all agreements and conditions contained in this Agreement required to be performed or complied with by it prior to or at the Closing and, after giving effect to the issuance and sale of the Notes (and the application of the proceeds thereof as contemplated by Section 5.12), no Default or Event of Default shall have occurred and be continuing. The Company shall not have entered into any transaction since September 30, 2005, that would have been prohibited by Section 10 hereof had such Section applied since such date.

4.3. COMPLIANCE CERTIFICATES AND ORGANIZATIONAL DOCUMENTS.

(a) Officer's Certificate. The Company shall have delivered to you an Officer's Certificate, dated as of the Closing Date, certifying on behalf of the Company that the conditions specified in Sections 4.1, 4.2 and 4.7 have been fulfilled.

(b) Secretary's Certificates. The Company shall have delivered to you copies of the by-laws of the Company and each of its Subsidiaries (collectively, the "GROUP MEMBERS") and of the resolutions of the Board of Directors of the Company relating to the authorization, execution and delivery of the Notes, certified by the Secretary or Assistant Secretary of the Company, and an incumbency certificate executed by such Secretary or Assistant Secretary.

(c) Organizational Documents. The Company shall have delivered to you copies of the articles of incorporation of each of the Group Members, certified as of a recent date by the Secretary of State of the Commonwealth of Puerto Rico or, if a copy certified by the Secretary of State is unavailable on the Closing Date, certified by the Secretary or Assistant Secretary of each Group Member, and good standing certificates for each Group Member from such Secretary of State or, in the case of each Subsidiary that is an insurance company, from the Commissioner of Insurance of Puerto Rico.

2

4.4. OPINIONS OF COUNSEL.

You shall have received opinions from (a) Pietrantoni Mendez & Alvarez LLP, special counsel to the Company, and (b) Enrique R. Ubarri Baragano, Senior Vice President, Legal Affairs, of the Company, each dated as of the Closing Date, substantially in the respective forms set forth as Exhibits 2-A and 2-B. This Section 4.4 shall constitute direction by the Company to such counsel named in the foregoing clauses (a) and (b) to deliver the opinions specified to you at the Closing.

4.5. PURCHASE PERMITTED BY APPLICABLE LAW, ETC.

On the Closing Date, your purchase of Notes shall (i) be permitted by the laws and regulations of each jurisdiction to which you are subject, without recourse to provisions of law permitting limited investments by financial institutions without restriction as to the character of the particular investment, (ii) not violate any applicable law or regulation and (iii) not subject you to any tax, penalty or liability under or pursuant to any applicable law or regulation, which law or regulation was not in effect on the date hereof.

4.6. PRIVATE PLACEMENT NUMBER.

A Private Placement number issued by Standard & Poor's CUSIP Service Bureau shall have been obtained for the Notes.

4.7. CHANGES IN CORPORATE STRUCTURE.

The Company shall not have changed its jurisdiction of incorporation or been a party to any merger or consolidation. The Company shall not have succeeded to all or any substantial part of the liabilities of any other entity following the date of the most recent financial statements referred to in Schedule 5.3.

4.8. PROCEEDINGS AND DOCUMENTS.

All corporate and other proceedings in connection with the transactions contemplated by this Agreement and all documents and instruments incident to such transactions shall be reasonably satisfactory to you and your counsel, and you and your counsel shall have received all such counterpart originals or certified or other copies of such documents as you or they may reasonably request.

5. REPRESENTATIONS AND WARRANTIES OF THE COMPANY.

The Company represents and warrants to you as follows:

5.1. ORGANIZATION; POWER AND AUTHORITY.

Each Group Member is a corporation duly organized, validly existing and in good standing under the laws of the Commonwealth of Puerto Rico, and is duly qualified as a foreign corporation and is in good standing in each jurisdiction in which such qualification is required by law, other than those jurisdictions as to which the failure to be so qualified or in good standing

3

would not, individually or in the aggregate, reasonably be expected to have a Material Adverse Effect. The Company and each Subsidiary has the corporate power and authority to conduct its business as presently conducted and as proposed to be conducted after the Acquisition. The Company has the corporate power and authority to execute and deliver this Agreement and the Notes and to perform the provisions hereof and thereof.

5.2. AUTHORIZATION, ETC.

This Agreement has been, and on the Closing Date the Notes will be, duly authorized by all necessary corporate action on the part of the Company, and this Agreement constitutes, and upon execution and delivery thereof by the Company each Note issued to you will constitute, a legal, valid and binding obligation of the Company (assuming with respect to this Agreement and any Notes issued to you, the due authorization, execution and delivery of this Agreement by you), enforceable against the Company in accordance with its terms, except as such enforceability may be limited by (i) applicable bankruptcy, insolvency, reorganization, moratorium or other similar laws affecting the enforcement of creditors' rights generally from time to time in effect and (ii) the application of equitable principles and the availability of equitable remedies.

5.3. FINANCIAL STATEMENTS.

(a) The Company has delivered to you copies of the financial statements of the Company listed on Schedule 5.3 (such financial statements collectively the "FINANCIAL STATEMENTS").

(b) The Financial Statements (including in each case the related schedules and notes) fairly present in all material respects the consolidated financial position of the Company and its Subsidiaries as of the respective dates specified in such Financial Statements and the consolidated results of its operations and cash flows for the respective periods so specified in accordance with GAAP consistently applied throughout such periods except as set forth in the notes thereto (subject, in the case of any interim financial statements, to normal year-end adjustments).

(c) Since the date of the most recent Financial Statement, there has been no material adverse change in the business, operations or condition (financial or otherwise) of the Company and its Subsidiaries taken as a whole, and no event that could reasonably be expected to have a Material Adverse Effect, and the Company has not incurred any material Indebtedness for Borrowed Money or entered into any material transaction other than as disclosed to the Purchasers.

(d) The Company maintains a system of internal accounting controls sufficient to provide reasonable assurance that (i) transactions are executed in accordance with management's general or specific authorization, (ii) transactions are recorded as necessary to permit preparation of financial statements in conformity with GAAP and to

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maintain accountability for assets, (iii) access to assets is permitted only in accordance with management's general or specific authorization, and (iv) the recorded accountability for assets is compared with existing assets at reasonable intervals and appropriate action is taken with respect to any differences.

5.4. COMPLIANCE WITH LAWS, OTHER INSTRUMENTS, ETC.

The execution, delivery and performance by the Company of this Agreement and the Notes will not (i) in any material respect contravene, result in any breach of, or constitute a default under, or result in the creation of any Lien in respect of any property of the Company or any of its Significant Subsidiaries under, any indenture, mortgage, deed of trust, loan, purchase or credit agreement, lease, corporate charter or by-laws, or any other material agreement or instrument to which the Company or any such Significant Subsidiary is bound or by which the Company or any such Significant Subsidiary or their respective properties may be bound or affected, (ii) conflict with or result in a material breach of any of the terms, conditions or provisions of any order, judgment, decree or ruling of any court, arbitrator or Governmental Authority applicable to the Company or any of its Significant Subsidiaries, or (iii) violate any provision of any statute or other rule or regulation of any Governmental Authority applicable to the Company or any of its Significant Subsidiaries.

5.5. GOVERNMENTAL AUTHORIZATIONS, ETC.

No consent, approval or authorization of, or registration, filing or declaration with, any Governmental Authority is required for the due execution, delivery or performance by the Company of this Agreement or the Notes.

5.6. LITIGATION; OBSERVANCE OF STATUTES AND ORDERS.

(a) Except as disclosed in Schedule 5.6, there are no actions, suits or proceedings pending or, to the knowledge of the Company, threatened against or affecting the Company or any of its Significant Subsidiaries or any property of the Company or of its Significant Subsidiaries in any court or before any arbitrator or administrative agency of any kind or before or by any Governmental Authority that, if determined adversely to the Company or any of its Significant Subsidiaries, individually or in the aggregate, would reasonably be expected to have a Material Adverse Effect.

(b) Neither the Company nor any of its Significant Subsidiaries is in default under any order, judgment, decree or ruling of any court, arbitrator or Governmental Authority or in violation of any applicable law, ordinance, rule or regulation of any Governmental Authority, which default or violation, individually or in the aggregate, would reasonably be expected to have a Material Adverse Effect.

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5.7. TAXES.

Each of the Company and its Significant Subsidiaries has filed all income tax returns that are required to have been filed, except for any filings which failure to make would not be reasonably expected to have a Material Adverse Effect, and has paid all taxes shown to be due and payable on such returns and all other taxes payable by it, to the extent such taxes have become due and payable, except for any taxes (i) the amount of which would not individually or in the aggregate reasonably be expected to have a Material Adverse Effect or (ii) the amount, applicability or validity of which is currently being contested in good faith by appropriate proceedings and with respect to which the Company and each such Significant Subsidiary has established adequate reserves in accordance with GAAP. The Company is not aware of any tax deficiency that, if determined adversely to the Company or any Significant Subsidiary, could reasonably be expected to result in a Material Adverse Effect.

5.8. TITLE TO PROPERTY; LEASES.

Each of the Company and its Significant Subsidiaries has good and sufficient title to its respective material properties, free and clear of Liens, except for (i) Liens described in Schedule 5.8, and (ii) defects in title that, individually or in the aggregate, would not have a Material Adverse Effect. All material leases entered into by the Company and its Significant Subsidiaries are valid and subsisting and are in full force and effect in all material respects.

5.9. LICENSES, PERMITS, ETC.

The Company and each of its Significant Subsidiaries owns or possesses all licenses, permits, franchises, authorizations, patents, copyrights, service marks, trademarks and trade names, or rights thereto, that are material to its business, without known conflict with the rights of others, except for those conflicts that, individually or in the aggregate, would not have a Material Adverse Effect.

5.10. COMPLIANCE WITH ERISA.

(a) Each of the Company, its Significant Subsidiaries and each of their respective ERISA Affiliates has operated and administered each Plan in compliance in all material respects with all applicable laws except for such instances of noncompliance as have not resulted in and would not reasonably be expected to result in a Material Adverse Effect. None of the Company, its Significant Subsidiaries nor their respective ERISA Affiliates has incurred any liability pursuant to Title I or IV of ERISA or applicable penalty or excise tax provisions of the PRIRC relating to employee benefit plans (as defined in section 3 of ERISA), and no event, transaction or condition has occurred or exists that would reasonably be expected to result in the incurrence of any such liability by the Company, its Significant Subsidiaries or any of such ERISA Affiliates, or in the imposition of any Lien on any of the rights, properties or assets of the Company, its Significant Subsidiaries or any of such ERISA Affiliates, in either case pursuant to Title I or IV of ERISA or to such penalty or excise

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tax provisions of the PRIRC, other than in any of such cases, such liabilities or Liens as would not reasonably be expected to result, individually or in the aggregate, in a Material Adverse Effect.

(b) None of the Company, its Significant Subsidiaries nor their respective ERISA Affiliates has incurred withdrawal liabilities (or is subject to contingent withdrawal liabilities) under section 4201 or 4204 of ERISA in respect of Multiemployer Plans that individually or in the aggregate would reasonably be expected to result in a Material Adverse Effect.

(c) The execution and delivery of this Agreement and the issuance and sale of the Notes hereunder will not involve any transaction that is subject to the prohibitions of section 406 of ERISA or in connection with which a tax could be imposed pursuant to the PRIRC. The representation by the Company in the first sentence of this Section 5.10(c) is made in reliance upon and subject to (i) the accuracy of your representation in Section 6.2 as to the sources of the funds to be used to pay the purchase price of the Notes to be purchased by you and (ii) the assumption, made solely for the purpose of making such representation, that Department of Labor Interpretive Bulletin 75-2 with respect to prohibited transactions remains valid in the circumstances of the transactions contemplated herein.

5.11. PRIVATE OFFERING BY THE COMPANY.

Neither the Company nor UBS Financial Services Incorporated of Puerto Rico, as placement agent (the only Person authorized or employed by the Company as agent, broker, dealer or finder in connection with the offering or sale of the Notes) has offered any of the Notes or any similar securities (other than the Company's 6.60% Senior Unsecured Notes due December 2020) for sale to, or solicited any offer to buy any of the same from, or otherwise approached or negotiated in respect thereof with, any Person other than you. As used in the preceding sentence, "SIMILAR SECURITY" means a security which would be integrated with the offering of the Notes under applicable securities laws. Neither the Company nor such agent has taken, or will take, any action that would subject the issuance or sale of the Notes to the registration requirements of Section 5 of the Securities Act.

5.12. USE OF PROCEEDS.

The Company will apply the proceeds from the sale of the Notes to finance the acquisition of 100% of the capital stock of Great American Life Assurance Company of Puerto Rico and to pay a portion of the related transaction expenses.

5.13. EXISTING INDEBTEDNESS FOR BORROWED MONEY.

Schedule 5.13 sets forth a complete and correct list of all outstanding Indebtedness for Borrowed Money in the principal amount of at least Five Million United States Dollars (US$5,000,000) of the Company and its Significant Subsidiaries as of September 30, 2005, since which date there has been no material change in the amounts, interest rates, sinking funds, installment payments or maturities of such Indebtedness for Borrowed Money. Neither

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the Company nor any of its Significant Subsidiaries is in default (and no waiver of any such default is currently in effect) in the payment of any principal or interest on, and no Event of Default exists with respect to, any such Indebtedness for Borrowed Money.

5.14. INVESTMENT COMPANY ACT.

The Company is not subject to regulation under the Investment Company Act of 1940, as amended.

5.15. DISCLOSURE.

No statement or information contained in this Agreement or any other document, certificate or statement furnished to the Purchasers or any of them, by or on behalf of the Company in connection with the transactions contemplated by this Agreement contained as of the date such statement, information, document or certificate was so furnished any untrue statement of a material fact or omitted to state a material fact necessary in order to make the statements contained herein or therein in the light of the circumstances in which they were made not misleading. The projections and pro forma financial information contained in the materials referenced above are based upon good faith estimates and assumptions believed by management of the Company to be reasonable at the time made, it being recognized by the Purchasers that such financial information as it relates to future events is not to be viewed as fact and that actual results during the period or periods covered by such financial information may differ from the projected results set forth therein by a material amount.

5.16. LABOR DISPUTES.

None of the Company nor its Significant Subsidiaries is engaged in any labor dispute that could reasonably be expected to have a Material Adverse Effect.

5.17. SOURCE OF INCOME.

The Company has derived more than 20 percent of its gross income from Commonwealth of Puerto Rico sources on an annual basis since its incorporation in accordance with the applicable sourcing rules under the Code.

6. REPRESENTATIONS OF THE PURCHASER.

You hereby represent and warrant to the Company as follows:

6.1. PURCHASE FOR INVESTMENT; ACCREDITED INVESTOR.

(a) You are purchasing the Notes for your own account and not with a view to, or for sale in connection with, the distribution thereof within the meaning of the Securities Act, provided that you have the right to dispose of the Notes, or any part thereof, if you deem it advisable to do so, either pursuant to a registration of the Notes under the Securities Act or pursuant to an applicable exemption from the registration requirements of the

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Securities Act. You understand that the Notes have not been registered under the Securities Act or the Puerto Rico Uniform Securities Act, as amended ("PRUSA"), and you understand and agree that the Notes may be resold only if registered pursuant to the provisions of the Securities Act or if an exemption from registration is available thereunder.

(b) You are an "ACCREDITED INVESTOR" as defined in Rule 501(a) under the Securities Act.

(c) It is understood that, in making the representations set out in Sections 5.4, 5.5 and 5.10 hereof, the Company is relying, to the extent applicable, upon your representations set forth in this
Section 6.1.

(d) (i) You have consulted with your own legal and tax advisers in connection herewith to the extent you have deemed necessary, (ii) you have had a reasonable opportunity to ask questions of and receive answers from officers and representatives of the Company and its Subsidiaries concerning their respective financial condition and results of operations and any other matter relevant to the purchase of the Notes, and any such questions have been answered to your satisfaction, (iii) you have had the opportunity to review all publicly available records and filings concerning the Company and its Subsidiaries, and (d) you have made your own investment decisions based upon your own judgment, due diligence and advice from such advisers as you have deemed necessary and upon the representations made by the Company herein.

6.2. SOURCE OF FUNDS.

At least one of the following statements is an accurate representation as to each source of funds (a "SOURCE") to be used by you to pay the purchase price of the Notes to be purchased by you hereunder:

(a) all or part of the Source constitutes assets of a bank collective investment fund, as contemplated by PTE 91-38, maintained by you, and you have disclosed to the Company the names of such employee benefit plans whose assets in such bank collective investment fund exceed ten percent of the total assets or are expected to exceed ten percent of the total assets of such fund as of the date of such purchase (for the purpose of this clause (a), all employee benefit plans maintained by the same employer or employee organization are deemed to be a single plan);

(b) all or part of the Source constitutes assets of one or more employee benefit plans, each of which has been identified to the Company in writing;

(c) you are acquiring the Notes for the account of one or more pension funds, trust funds or agency accounts, each of which is a "GOVERNMENTAL PLAN" (as defined in section 3(32) of ERISA) and the investment does not give rise to any violation of any federal, state or local law which is substantially

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similar to Title I of ERISA, section 4975 of the Code or comparable provisions of the PRIRC;

(d) the Source is an "INVESTMENT FUND" managed by a "QUALIFIED PROFESSIONAL ASSET MANAGER" or "QPAM" (as defined in Part V of PTE 84-14, issued March 13, 1984), provided that (i) no other party to the transaction described in this Agreement and no "AFFILIATE" of such party (as defined in Part V(c) of PTE 84-14) has at this time, and during the immediately preceding one year none has exercised, the authority to appoint or terminate said QPAM as manager of the assets of any plan identified in writing pursuant to this clause (d) or to negotiate the terms of said QPAM's management agreement on behalf of any such identified plans, (ii) the conditions set forth in paragraphs (c), (d), (e),
(f) and (g) of Part I of PTE 84-14 are satisfied; and (iii) you have disclosed to the Company the name of the QPAM and of all employee benefit plans whose assets are included in such investment fund;

(e) the Source is a "PLAN" managed by an "IN-HOUSE ASSET MANAGER" or "INHAM" (as defined in Part IV of PTE 96-23, issued April 10, 1996), provided that the conditions set forth in paragraphs (a),
(c), (d), (e), (f), (g) and (h) of Part I of PTE 96-23 are satisfied; or

(f) none of such funds consists of assets of any "EMPLOYEE BENEFIT PLAN" as defined in ERISA or any "PLAN" as defined in section 4975 of the Code or comparable provisions of the PRIRC, other than an employee benefit plan or plan exempt from the coverage of ERISA and section 4975 of the Code.

As used in this Section 6.2, the terms "EMPLOYEE BENEFIT PLAN," "GOVERNMENTAL PLAN," "PARTY IN INTEREST" and "SEPARATE ACCOUNT" shall have the respective meanings assigned to such terms in section 3 of ERISA. If you breach any representation made by you under this Section 6.2, your purchase of the Notes shall be void ab initio.

6.3. ANTI-MONEY LAUNDERING.

(a) The funds that you are using to purchase the Notes were not directly or indirectly derived from activities that may contravene federal, state and international laws and regulations, including Anti-Money Laundering Laws; and

(b) to the best of your knowledge, neither:

(i) you, nor

(ii) any person controlling, controlled by, or under common control with you,

(1) is a country, territory, individual or entity named on an Office of Foreign Assets Control ("OFAC") list, or is an individual or entity that resides or has a

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place of business in a country or territory named on such lists, (2) is a "senior foreign political figure," or any "immediate family member" or "close associate" (as such terms are defined in the Patriot Act) of a senior foreign political figure or (3) is a "foreign shell bank" (as defined in the Patriot Act) or transacts business with a foreign shell bank.

You understand that the Company may not accept any payments for the Notes from you if you cannot make the representations set forth above.

6.4. TRANSFEREE.

Any transferee of a Note shall, by its acceptance of such Note, be deemed to have made the same representations regarding the purchase of the Notes as the original holder thereof made pursuant to Sections 6.1, 6.2 and 6.3 above.

7. INFORMATION AS TO THE COMPANY.

7.1. FINANCIAL AND BUSINESS INFORMATION.

The Company shall deliver to you and to any subsequent holder of Notes that is an Institutional Investor, subject to the proviso contained at the end of Section 7.2 hereof:

(a) SEC and Other Reports--for so long as the Company is subject to reporting obligations under the Securities Exchange Act of 1934, as amended (the "EXCHANGE ACT") with respect to any of its securities, within ten (10) days after it files them with the U.S. Securities and Exchange Commission (the "SEC"), one copy of its annual report and of the information, documents and other reports which the Company is required to file with the SEC pursuant to Section 13 or 15(d) of the Exchange Act; provided that no such delivery shall be required as to any of such reports and documents which have been filed and are available in electronic format at the SEC's EDGAR database. In the event that the Company is at any time no longer subject to the reporting requirements of Section 13 or 15(d) the Exchange Act, the Company shall provide to you and each subsequent note holder that is an Institutional Investor, (1)(i) within sixty (60) days after the end of each of the first three quarterly fiscal periods in each fiscal year of the Company: an unaudited consolidated balance sheet of the Company as at the end of such quarter, and the related unaudited consolidated statements of income and cash flows of the Company for such quarter; and (ii) within one hundred twenty (120) days after the end of each fiscal year of the Company, the consolidated audited balance sheet of the Company and the related consolidated statements of income and cash flows of the Company for such year; and (2) at your request,
(i) a quarterly presentation which shall include a discussion by the Company's management of the most recent financial and operational results of the Company and its Significant Subsidiaries on a consolidated basis and a discussion of the Company's

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most recent business plans and projections, and (ii) on a yearly basis, a written report reflecting a discussion by the Company's management of the financial and operational results of the Company and its Significant Subsidiaries on a consolidated basis as of the year ended. In addition, on a quarterly basis, the Company's designated legal counsel, at your request, will provide you and your designated legal counsel, access to material and recent information so as to provide an update to the status of all material legal actions, suits or proceedings;

(b) Notice of Default or Event of Default--within ten (10) days after a Responsible Officer becomes aware of the existence of any condition or event which constitutes a Default or Event of Default, a written notice specifying the nature thereof and what action the Company is taking or proposes to take with respect thereto;

(c) Compliance Certificate--concurrently with the delivery of any financial statements pursuant to Section 7.1(a), a certificate of a Responsible Officer stating that, to the best of such Responsible Officer's knowledge, the Company and each Subsidiary during such period has observed or performed all of its covenants and other agreements, and satisfied every condition, contained in this Agreement, and that such Responsible Officer has obtained no knowledge of any Default or Event of Default except as specified in such certificate; and

(d) Notice of Reduction in Risk-based Capital Ratio--within fifteen
(15) days after the end of any month in which the Company's Risk-based Capital Ratio shall be lower than 375%, a written notice specifying the Company's Risk-based Capital Ratio as of the end of such month and what action the Company is taking or proposes to take with respect thereto.

7.2. INSPECTION.

The Company shall permit each holder of Notes that is an Institutional Investor, or a group of Institutional Investors that are (i) Puerto Rico licensed investment companies advised by the same investment adviser and (ii) Purchasers and holders of Notes, and holds Notes with an aggregate principal amount of at least Ten Million United States Dollars (US$10,000,000), or at least Five Million United States Dollars (US$5,000,000) in the case of such group, together with their respective representatives, at the expense of the Company if done in connection with an Event of Default, to visit and inspect any of the offices or properties of the Company and its Significant Subsidiaries to examine their books and records, and to discuss their affairs, finances and accounts with their officers, employees and independent public accountants (and by this provision, the Company authorizes said accountants to discuss the finances and affairs of the Company and its Significant Subsidiaries, but any such discussions shall be arranged by the Company and the Company shall have the opportunity to participate therein) all at such reasonable times and as may be reasonably requested in relation to the performance by the Company of its obligations under the Notes or under this Agreement;

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provided, however, that the Company (or any such Significant Subsidiary) shall not be required to disclose to any such holder of Notes (or to any of its representatives) information to the extent that the Company (or any such Significant Subsidiary) is advised by internal or external legal counsel that it is prohibited from disclosing such information at such time to its creditors generally under applicable laws, rules, regulations or orders (or other binding restrictions imposed by Governmental Authorities or agreements entered into in good faith with third parties that are not Affiliates of the Company).

8. PAYMENT OF INTEREST.

The Company shall pay interest (computed on the basis of a 360-day year of twelve 30-day months) (a) on the unpaid balance of the Notes at the rate of 6.70% per annum from the date of the Notes, payable monthly in arrears, on the first (1st) day of each month, commencing on March 1, 2006, until the principal of the Notes shall have become due and payable and (b) to the extent permitted by law, on any overdue payment (including any overdue prepayment) of principal and any overdue payment of interest, payable monthly as aforesaid (or, at the option of the registered holder hereof, on demand), at a rate per annum from time to time equal to the Default Rate. Notwithstanding the above, in the event that the Company's Risk-based Capital Ratio is less than 375% during a period of at least one year, the interest rate payable on the Notes on any interest payment date after the expiration of such year shall increase to 6.85% per annum while such condition exists. The interest so payable on any interest payment date will be paid to the Holder in whose name a Note is registered at the close of business on the fifteenth (15th) calendar day (whether or not a Business Day) next preceding such interest payment date.

9. REDEMPTION OF THE NOTES PRIOR TO MATURITY.

9.1. OPTIONAL REDEMPTION.

The Company may, at its option, upon notice as provided below, redeem and prepay prior to maturity from time to time, all or any part of the Notes on or after February 1, 2011, at a price equal to 100% of the principal amount of the Notes to be redeemed together with accrued and unpaid interest, if any, to the date of redemption specified by the Company (the "REDEMPTION DATE").

The Company will give each holder of Notes written notice of any redemption under this Section 9.1 not less than thirty (30) days and not more than sixty (60) days prior to any Redemption Date. Each such notice shall specify the Redemption Date, the aggregate principal amount of the Notes to be redeemed on such Redemption Date, the principal amount of each Note held by such holder to be redeemed (determined in accordance with Section 9.2), and the interest to be paid on such Redemption Date with respect to such principal amount being redeemed.

9.2. ALLOCATION OF PARTIAL REDEMPTIONS.

In the case of any partial redemption of the Notes, the principal amount of the Notes to be redeemed shall be allocated among all of the Notes at the time outstanding in

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proportion, as nearly as practicable, to the respective unpaid principal amounts thereof not theretofore called for redemption.

9.3. MATURITY; SURRENDER, ETC.

In the case of each redemption of Notes pursuant to this Section 9, the principal amount of each Note to be redeemed shall mature and become due and payable on the respective Redemption Date, together with interest on such principal amount accrued to such date. From and after such date, unless the Company shall fail to pay such principal amount when so due and payable, together with the interest thereon, interest on such principal amount shall cease to accrue. Any Note paid or redeemed in full shall be surrendered to the Company and cancelled and shall not be reissued, and no Note shall be issued in lieu of any prepaid principal amount of any Note.

9.4. PURCHASE OF NOTES.

The Company will not, and the Company will not permit any of its Affiliates to, purchase, redeem, prepay or otherwise acquire, directly or indirectly, any of the outstanding Notes except (i) pursuant to an offer made to all holders of the Notes or (ii) upon the payment or redemption of the Notes in accordance with the terms of this Agreement and the Notes. The Company will promptly cancel all Notes acquired by it or any of its Affiliates pursuant to any payment, redemption or purchase of Notes pursuant to any provision of this Agreement and no Notes may be issued in substitution or exchange for any such Notes.

10. BUSINESS COVENANTS.

The Company covenants that, so long as the Notes are outstanding, it will, and it will cause each of its Significant Subsidiaries to:

10.1. COMPLIANCE WITH LAWS.

Comply with all laws, ordinances and governmental rules and regulations to which it is subject and obtain and maintain in effect all licenses, certificates, permits, franchises and other governmental authorizations necessary to the ownership of its properties or to the conduct of its businesses, in each case to the extent necessary to ensure that non-compliance with such laws, ordinances or governmental rules or regulations or failures to obtain or maintain in effect such licenses, certificates, permits, franchises and other governmental authorizations would not reasonably be expected, individually or in the aggregate, to have a Material Adverse Effect.

10.2. INSURANCE.

Except where the failure to comply would not reasonably be expected to have a Material Adverse Effect, maintain, with financially sound and reputable insurers, insurance with respect to its properties and business against such casualties and contingencies, of such types, on such terms and in such amounts (including deductibles, co-insurance and self-insurance, if adequate reserves are maintained with respect thereto) as is customary in the case of entities of established reputations engaged in the same or a similar business and similarly situated.

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10.3. PAYMENT OF TAXES.

File all tax returns required to be filed and pay and discharge or cause to be paid or discharged all taxes shown to be due and payable on such returns and all other taxes and assessments payable by it, to the extent such taxes and assessments have become due and payable, provided that the Company or such Significant Subsidiary need not (a) make any filing the failure to make which would not be reasonably expected to have a Material Adverse Effect or (b) pay any such tax or assessment if (i) the amount, applicability or validity thereof is contested by the Company or such Significant Subsidiary on a timely basis in good faith and in appropriate proceedings, and the Company or such Significant Subsidiary has established adequate reserves therefor in accordance with GAAP on their respective books, or (ii) the nonpayment of all such taxes and assessments in the aggregate would not reasonably be expected to have a Material Adverse Effect.

10.4. USE OF PROCEEDS.

Apply the proceeds from the sale of the Notes for the purposes set forth in Section 5.12 hereof within twenty-four (24) months from the date of the issuance of the Notes. The Company will notify Treasury of such use as required by Section 1013A of the PRIRC.

If a favorable ruling from Treasury is obtained after the Closing Date, by purchasing the Notes, the subsequent holders of the Notes, other than the Purchasers, will be deemed to have made an election under Section 1013A of the PRIRC and the 10 percent preferential withholding tax will be made on the interest on the Notes unless such holders elect out of such withholding by providing a written statement to that effect to the Company, through certified mail, in the form set forth in Exhibit 3.

10.5. CORPORATE EXISTENCE, ETC.

Subject to the provisions of Sections 11.2 and 11.4 hereof, the Company will do or cause to be done all things necessary to preserve and keep in full force and effect the corporate existence, rights (charter and statutory) and franchises of the Company and each Significant Subsidiary; provided, however, that the Company shall not be required to preserve any such right or franchise or corporate existence of a Significant Subsidiary if the Company shall determine that the preservation thereof is no longer desirable in the conduct of the business of the Company and that the loss thereof is not disadvantageous in any material respect to the holders of the Notes.

10.6. SOURCE OF INCOME.

The Company shall do or cause to be done all things necessary or proper within its control to ensure that, for purposes of the Code, interest paid on the Notes will constitute income from sources within the Commonwealth of Puerto Rico.

10.7. LINES OF BUSINESS.

The Company will continue to be a Blue Cross/Blue Shield licensee and will be principally engaged in the business of providing health, life and property and casualty insurance.

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11. NEGATIVE COVENANTS.

The Company covenants that, so long as any of the Notes is outstanding, it will not:

11.1. TRANSACTIONS WITH AFFILIATES.

Enter into, or permit any of its Significant Subsidiaries to enter into, directly or indirectly, into any transaction or group of related transactions which, in the opinion of the management of the Company, is material to the Company and its Subsidiaries taken as a whole (including without limitation the purchase, lease, sale or exchange of properties of any kind or the rendering of any service) with any of its Affiliates, except (i) pursuant to its reasonable business requirements and (ii) in the case of transactions with Affiliates other than wholly owned Subsidiaries, on arm's length terms.

11.2. CONSOLIDATION, MERGER AND SALE OF ASSETS.

Not consolidate with or merge into, or convey, transfer or lease its properties and assets substantially as a whole to, any Person, unless:

(a) the Company is the surviving or continuing entity, or the entity formed by such consolidation or into which the Company is merged or to which the Company has conveyed, transferred or leased its properties and assets substantially as an entirety is an entity organized and validly existing under the laws of the United States of America, any province or state thereof or the District of Columbia or the Commonwealth of Puerto Rico, and such entity expressly assumes the Company's obligations under the Notes by an agreement supplemental hereto;

(b) immediately after giving effect to the transaction, no Default shall have occurred and be continuing; and

(c) the Company shall have delivered to each holder an Officer's Certificate and an opinion of counsel, each stating that such consolidation, merger or transfer and such supplemental agreement (if any) comply with this Agreement.

Notwithstanding the provisions of this Section 11.2, any wholly owned Subsidiary may merge or consolidate with the Company or another wholly owned Subsidiary so long as the Company or such wholly owned Subsidiary shall be the surviving or continuing corporation.

11.3. LIMITATION UPON CREATION OF LIENS ON VOTING STOCK OF SIGNIFICANT SUBSIDIARIES.

Incur, issue, assume or guarantee, nor permit any Significant Subsidiary to incur, issue, assume or guarantee, any Indebtedness for Borrowed Money, directly or indirectly secured by a Lien in any shares of voting stock of any Significant Subsidiary without making effective provision whereby the Notes (and, if the Company so elects, any other indebtedness of the Company ranking on a parity with the Notes) shall be secured equally and ratably with such

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secured indebtedness; provided, however, that the foregoing covenant shall not apply to (i) any Lien in any shares of voting stock of any corporation existing at the time such corporation becomes a Significant Subsidiary; (ii) Liens for taxes or assessments or governmental charges (a) not then due and delinquent or
(b) the validity of which is being contested in good faith or (c) which are less than Five Million United States Dollars (US$5,000,000) in amount; (iii) Liens (other than consensual Liens) created or resulting from any litigation or legal proceeding (a) which is currently being contested in good faith by appropriate proceedings, (b) which involves claims of less than Five Million United States Dollars (US$5,000,000), or (iv) deposits to secure (or in lieu of) surety, stay, appeal or custom bonds.

If the Company shall hereafter be required to secure the Notes equally and ratably with any other indebtedness of the Company pursuant to this Section 11.3 hereof, the Company shall promptly deliver to the holders an Officer's Certificate stating that the foregoing covenant has been complied with, and an opinion of counsel stating that in the opinion of such counsel the foregoing covenant has been complied with and that any instruments executed by the Company or any Subsidiary in the performance of the foregoing covenant comply with the requirements of the foregoing covenant.

11.4. LIMITATION UPON DISPOSITION OF VOTING STOCK OF, AND MERGER AND SALE OF ASSETS OF, PRINCIPAL INSURANCE SUBSIDIARY.

Subject to the provisions of Section 11.2 hereof, (i) sell, assign, transfer or otherwise dispose of any shares of, securities convertible into or options, warrants or rights to subscribe for or purchase shares of, voting stock (other than directors' qualifying shares) of its Principal Insurance Subsidiary or permit its Principal Insurance Subsidiary to issue (except to the Company) any shares of, securities convertible into or options, warrants or rights to subscribe for or purchase shares of, voting stock of the Principal Insurance Subsidiary, except for sales, assignments, transfers or other dispositions that:

(a) are for fair market value on the date thereof, as determined by the Board of Directors of the Company (which determination shall be conclusive) and, after giving effect to such disposition and to any possible dilution, the Company will own (directly or indirectly) not less than 80% of the shares of voting stock of its Principal Insurance Subsidiary then issued and outstanding free and clear of any Lien;

(b) are made in compliance with an order of a court or regulatory authority of competent jurisdiction, as a condition imposed by any such court or authority permitting the acquisition by the Company, directly or indirectly, of any other insurance company or health maintenance organization or entity the activities of which are legally permissible for a holding company of such entities or a subsidiary thereof to engage in, or as an undertaking made to such authority in connection with such an acquisition, which entity agrees to be bound by this covenant as the Principal Insurance Subsidiary; or

17

(c) are made after such Principal Insurance Subsidiary, having obtained any necessary regulatory approvals, unconditionally guarantees payment when due of the principal of and premium, if any, and interest on the Notes and agrees to comply with the restrictions that are applicable to it hereunder; or

(d) are made to the Company or any wholly owned Subsidiary if such wholly owned Subsidiary agrees to be bound by this covenant as the Principal Insurance Subsidiary and the Company agrees to maintain such wholly owned Subsidiary as a wholly owned Subsidiary.

or, (ii) permit the Principal Insurance Subsidiary to (a) merge or consolidate, unless the surviving corporation meets the requirements of the following paragraph; or (b) convey, transfer, lease or sell its properties and assets substantially as an entirety to any Person, except to an entity that meets the requirements of the following paragraph.

Notwithstanding the foregoing, the Principal Insurance Subsidiary may be merged into or consolidated with another insurance company or health maintenance organization organized under the laws of the United States of America, any province or state thereof, the Commonwealth of Puerto Rico or the District of Columbia if, after giving effect to such merger or consolidation, the Company or any wholly owned Subsidiary owns at least 80% of the voting stock of such other insurance company or health maintenance organization then issued and outstanding free and clear of any Lien and if, immediately after giving effect thereto and treating any such resulting institution thereafter as the Principal Insurance Subsidiary and as a Subsidiary for purposes of this Agreement, no Default has occurred and is continuing.

11.5. LIMITATION ON DIVIDENDS AND OTHER PAYMENT RESTRICTIONS AFFECTING SUBSIDIARIES.

Create or otherwise cause or permit to exist or become effective, or permit any of its Subsidiaries to create or otherwise cause or permit to exist or become effective, any consensual encumbrance or restriction on the ability of any Subsidiary to (i) pay dividends or make any other distribution on its capital stock, (ii) make any loans or advances to the Company, or (iii) transfer any of its property or assets to the Company, to the extent such encumbrance or restriction materially affects the ability of the Company to comply with all its material obligations, including its obligations hereunder. The foregoing limitations shall not apply to encumbrances or restrictions existing under or by reason of (a) any encumbrances or restrictions pursuant to an agreement in effect on the date of this Agreement, (b) any restrictions, with respect to a Person that is not a Subsidiary on the date of this Agreement, under any agreement in existence at the time such Person becomes a Subsidiary (unless such agreement was entered into in connection with, or in contemplation of, such Person becoming a Subsidiary on or after the date of this Agreement), (c) any restrictions existing under any agreement that amends, refinances or replaces the agreement containing restrictions described in the foregoing clauses (a) and
(b) and this clause (c), provided that the terms and conditions of any such restrictions, taken as a whole, are not materially less favorable to the Holders of the Notes than those under the agreement so amended, refinanced or replaced,
(d) customary non-assignment or sublease provisions of any lease governing a leasehold interest of any Subsidiary, (e) those imposed by

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applicable law or regulation, (f) those imposed by an agreement with a regulatory authority, and (g) any restrictions with respect to a Subsidiary imposed pursuant to an agreement which has been entered into for the sale or disposition of all or substantially all of the Capital Stock or assets of such Subsidiary. This Section 11.5 shall not apply as long as the Notes are rated in one of the four highest rating categories by any nationally recognized statistical rating organization.

11.6. LIMITATION ON ADDITIONAL INDEBTEDNESS.

Incur or permit any of its Subsidiaries to incur or become liable with respect to any Indebtedness for Borrowed Money, unless after giving pro forma effect to the incurrence of such indebtedness and the application of the proceeds thereof the Consolidated Debt Service Coverage Ratio of the Company shall be equal to or greater than 1.25 to 1.00. For purposes hereof, the Consolidated Debt Service Coverage Ratio, as of any date of determination, means the ratio of (1) net income for the most recent four fiscal quarters for which financial statements have been made available to the Holders, plus interest expense, depreciation and amortization for such period, to the extent deducted from revenues in calculating net income, to (2) principal and interest payable with respect to Indebtedness for Borrowed Money, all calculated on a consolidated basis for the Company and its Subsidiaries in accordance with GAAP. This Section 11.6 shall not apply as long as the Notes are rated in one of the four highest rating categories by any nationally recognized statistical rating organization.

11.7. WAIVER OF CERTAIN COVENANTS.

The Company may omit in any particular instance to comply with any term, provision or condition set forth in Sections 10.5, 11.3, 11.4, 11.5 and 11.6 hereof, if before the time for such compliance, the Majority Holders shall by act of such holders, either waive such compliance in such instance or generally waive compliance with such term, provision or condition, but no such waiver shall extend to or affect such term, provision or condition except to the extent expressly so waived, and, until such waiver shall become effective, the obligations of the Company in respect of such term, provision or condition shall remain in full force and effect.

12. EVENTS OF DEFAULT.

An "EVENT OF DEFAULT" shall exist if any of the following conditions or events shall occur and be continuing:

(a) failure to pay interest on the Notes for more than five (5) days after the payment is due; or

(b) failure to pay principal or premium, if any, on any Note when due, whether at maturity, upon redemption, by declaration of acceleration or otherwise; or

(c) any breach of Section 11.1 hereof, which breach remains unremedied for thirty (30) days; or

(d) any breach of Section 11.2, 11.3, 11.4, 11.5 or 11.6 hereof; or

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(e) failure by the Company or any Significant Subsidiary to observe or perform in any material respect any other covenant contained herein for thirty (30) days after the Majority Holders give written notice to the Company thereof; or

(f) the Company or any Significant Subsidiary shall default in the payment of any principal or interest due (regardless of amount) under any Indebtedness for Borrowed Money in an aggregate principal amount in excess of Five Million United States Dollars (US$5,000,000), which default shall have resulted in such Indebtedness for Borrowed Money becoming or being declared due and payable prior to the date on which it would otherwise have become due and payable, without such acceleration having been rescinded or annulled within thirty (30) days after written notice of such default shall have been given to the Company or such Significant Subsidiary, as the case may be, requesting such acceleration to be rescinded or annulled and stating the such notice is a "notice of default" hereunder; provided, that if such default shall be cured by the Company or such Significant Subsidiary or waived by the holders of such Indebtedness for Borrowed Money, the Event of Default hereunder by reason thereof shall likewise be deemed to have been cured without any action on the part of any of the holders; or

(g) any judgment or decree for the payment of money in excess of Five Million United States Dollars (US$5,000,000) shall be rendered against the Company or any Significant Subsidiary and shall not be fully covered by insurance, and there is a period of sixty
(60) days following such judgment during which such judgment or decree is not discharged, waived, or the execution thereof stayed; or

(h) the entry of a decree or order by a court having jurisdiction in the premises adjudging the Company or any Significant Subsidiary a bankrupt or insolvent, or approving as properly filed a petition seeking reorganization, arrangement, adjustment or composition of or in respect of the Company or any Significant Subsidiary under any applicable United States federal, state or provincial bankruptcy, insolvency, reorganization or other similar law, or appointing a receiver, liquidator, assignee, trustee, sequestrator or other similar official of the Company or any Significant Subsidiary or of any substantial part of its property or ordering the winding up or liquidation of its affairs, and the continuance of any such decree or order unstayed and in effect for a period of ninety (90) consecutive days; or

(i) the institution by the Company or any Significant Subsidiary of proceedings to be adjudicated a bankrupt or insolvent, or the consent by it to the institution of bankruptcy or insolvency proceedings against it, or the filing by it of a petition or answer or consent seeking reorganization or relief under any applicable United States federal, state or provincial bankruptcy, insolvency, reorganization or other similar law, or the consent

20

by it to the filing of any such petition or to the appointment of a receiver, liquidator, assignee, trustee, sequestrator or other similar official of the Company or any Significant Subsidiary or of any substantial part of its property, or the making by the Company or any Significant Subsidiary of a general assignment for the benefit of creditors, or the admission by it in writing of its inability to pay its debts generally as they become due and its willingness to be adjudicated a bankrupt, or the taking of corporate action by the Company or any Significant Subsidiary in furtherance of any such action.

13. REMEDIES ON DEFAULT, ETC.

13.1. ACCELERATION.

(a) If an Event of Default with respect to the Company described in paragraph (h) or (i) of Section 12 has occurred, all the Notes then outstanding shall automatically become immediately due and payable.

(b) If any other Event of Default has occurred and is continuing, the Majority Holders may, at their option, by notice given to the Company as provided for herein, declare all the Notes to be immediately due and payable.

Upon any Notes becoming due and payable under this Section 13.1, whether automatically or by declaration, such Notes will forthwith mature and the entire unpaid principal amount of such Notes, plus all accrued and unpaid interest thereon (to the full extent permitted by applicable law), shall all be immediately due and payable, in each and every case without presentment, demand, protest or further notice, all of which are hereby waived.

13.2. OTHER REMEDIES.

If any Default or Event of Default has occurred and is continuing, and irrespective of whether any Notes have become or have been declared immediately due and payable under Section 13.1, you may proceed to protect and enforce your rights by an action at law, suit in equity or other appropriate proceeding, whether for the specific performance of any agreement contained herein or in the Notes, or for an injunction against a violation of any of the terms hereof or thereof, or in aid of the exercise of any power granted hereby or thereby or by law or otherwise.

13.3. RESCISSION.

At any time after any Notes have been declared due and payable pursuant to clause (a) or (b) of Section 13.1, by written notice to the Company, the Majority Holders may rescind and annul any such declaration and its consequences if (i) the Company has paid all overdue interest on the Notes, all principal of the Notes that are due and payable and are unpaid other than by reason of such declaration, and all interest on such overdue principal and (to the extent permitted by applicable law) any overdue interest in respect of the Notes, at the Default Rate, (ii) all Events of Default and Defaults, other than non-payment of amounts that have become due solely by reason of such declaration, have been cured or have been waived pursuant

21

to Section 17, and (iii) no judgment or decree has been entered for the payment of any monies due pursuant hereto to the holders of the Notes. No rescission and annulment under this Section 13.3 will extend to or affect any subsequent Event of Default or Default or impair any right consequent thereon.

13.4. NO WAIVERS OR ELECTION OF REMEDIES, EXPENSES, ETC.

No course of dealing and no delay in exercising any right, power or remedy shall operate as a waiver thereof or otherwise prejudice the holder's rights, powers or remedies. No right, power or remedy conferred by this Agreement or by the Notes shall be exclusive of any other right, power or remedy referred to herein or therein or now or hereafter available at law, in equity, by statute or otherwise. Without limiting the obligations of the Company under
Section 15, the Company will pay on demand such further amount as shall be sufficient to cover all reasonable out-of-pocket costs and expenses incurred in any enforcement or collection under this Section 13, including, without limitation, reasonable attorneys' fees, expenses and disbursements.

14. REGISTRATION; EXCHANGE; SUBSTITUTION OF NOTES.

14.1. REGISTRATION OF NOTES.

The Company shall keep at its principal executive office a register for the registration and registration of transfers of the Notes. The name and address of each holder of one or more Notes, each transfer thereof and the name and address of each transferee of one or more Notes shall be registered in such register. Prior to due presentment for registration of transfer, the Person in whose name any Note shall be registered shall be deemed and treated as the owner and holder thereof for all purposes hereof, and the Company shall not be affected by any notice or knowledge to the contrary. If and as applicable, the Company shall give to any holder of a Note that is an Institutional Investor, promptly upon request therefor, a complete and correct copy of the names and addresses of all registered holders of Notes.

14.2. TRANSFER AND EXCHANGE OF NOTES.

Upon surrender of any Note at the principal executive office of the Company for registration of transfer or exchange (and in the case of a surrender for registration of transfer, duly endorsed or accompanied by a written instrument of transfer duly executed by the registered holder of such Note or his attorney duly authorized in writing and accompanied by the address for notices of each transferee of such Note or part thereof), the Company shall execute and deliver, at the Company's expense (except as provided below), one or more new Notes (as requested by the holder thereof) in exchange therefor, in an aggregate principal amount equal to the unpaid principal amount of the surrendered Note. Each such new Note shall be payable to such Person as such holder may request and shall be substantially in the form of Exhibit 1. Each such new Note shall be dated and bear interest from the date to which interest shall have been paid on the surrendered Note or dated the date of the surrendered Note if no interest shall have been paid thereon. The Company may require payment of a sum sufficient to cover any stamp tax or governmental charge imposed in respect of any such transfer of Notes. Notes shall not be transferred in denominations of less than One Million United States Dollars (US$1,000,000),

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provided that if necessary to enable the registration of transfer by a holder of its entire holding of Notes, one Note may be in a denomination of less than One Million United States Dollars (US$1,000,000). Any transferee, by its acceptance of a Note registered in its name (or the name of its nominee), shall be deemed to have made the representations set forth in Sections 6.1, 6.2 and 6.3.

14.3. REPLACEMENT OF NOTES.

Upon receipt by the Company of evidence reasonably satisfactory to it of the ownership of and the loss, theft, destruction or mutilation of any Note (which evidence shall be, in the case of an Institutional Investor which is the registered holder, notice from such Institutional Investor of such ownership and such loss, theft, destruction or mutilation), and

(a) in the case of loss, theft or destruction, of indemnity reasonably satisfactory to it (provided that if the holder of such Note is, or is a nominee for, the Purchasers or an Institutional Investor with a minimum net worth of at least One Hundred Million United States Dollars (US$100,000,000), such Person's own unsecured agreement of indemnity shall be deemed to be satisfactory), or

(b) in the case of mutilation, upon surrender and cancellation thereof,

the Company at its own expense shall execute and deliver, in lieu thereof, a new Note, dated and bearing interest from the date to which interest shall have been paid on such lost, stolen, destroyed or mutilated Note or dated the date of such lost, stolen, destroyed or mutilated Note if no interest shall have been paid thereon.

15. PAYMENTS ON NOTES.

15.1. PLACE OF PAYMENT.

Subject to Section 15.2, payments of principal becoming due and payable on the Notes shall be made in San Juan, Puerto Rico at the principal office of the Company in such jurisdiction. The Company may at any time, by notice to each holder of a Note, change the place of payment of the Notes so long as such place of payment shall be either a principal office of the Company in Puerto Rico or a principal office of a bank or trust company in Puerto Rico. Interest shall be payable by check mailed to the registered holders of the Notes at their address set forth in the registration books held by the Company or, in the case of holders of at least One Million United States Dollars (US$1,000,000) in aggregate principal amount, by wire transfer to the account set forth in such registration books.

15.2. HOME OFFICE PAYMENT.

So long as you or your nominee shall be the holder of any Note, and notwithstanding anything contained in Section 15.1 or in such Note to the contrary, the Company will pay all sums becoming due on such Note for principal, and interest by the method and at the address specified for such purpose below your name in Schedule A, or by such other method or at such other address as you shall have from time to time specified to the Company in writing for

23

such purpose, without the presentation or surrender of such Note or the making of any notation thereon, except that upon written request of the Company made concurrently with or reasonably promptly after payment or redemption in full of any Note, you shall surrender such Note for cancellation, reasonably promptly after any such request, to the Company at its principal executive office or at the place of payment most recently designated by the Company pursuant to Section
15.1. Prior to any sale or other disposition of any Note held by you or your nominee you will, at your election, either endorse thereon the amount of principal paid thereon and the last date to which interest has been paid thereon or surrender such Note to the Company in exchange for a new Note or Notes pursuant to Section 14.2. The Company will afford the benefits of this Section 15.2 to any Institutional Investor that is the direct or indirect transferee of any Note purchased by you under this Agreement and that has made the same agreement relating to such Note as you have made in this Section 15.2.

16. SURVIVAL OF REPRESENTATIONS AND WARRANTIES; ENTIRE AGREEMENT.

The representations and warranties contained in Section 5 hereof shall survive the execution and delivery of this Agreement, the Notes and the purchase by you of any Note or portion thereof or interest therein, regardless of any investigation made at any time by or on behalf of you. Such representations and warranties are not for the benefit of any subsequent holder of the Notes. All statements contained in any certificate or other instrument delivered by or on behalf of the Company to the Purchasers pursuant to this Agreement shall be deemed representations and warranties of the Company under this Agreement. Subject to the preceding sentence, this Agreement and the Notes embody the entire agreement and understanding between you and the Company and supersede all prior agreements and understandings relating to the subject matter hereof.

17. AMENDMENT AND WAIVER.

17.1. REQUIREMENTS.

This Agreement and the Notes may be amended, and the observance of any term hereof or of the Notes may be waived (either retroactively or prospectively), with (and only with) the written consent of the Majority Holders and the Company, except that (a) no amendment or waiver of any of the provisions of Sections 1, 2, 3, 4, 5 or 6 hereof, or any defined term (as it is used therein), will be effective as to you unless consented to by you in writing, and
(b) no such amendment or waiver may, without the written consent of the holder of each Note at the time outstanding affected thereby, (i) subject to the provisions of Section 13 relating to acceleration or rescission, change the amount or time of any redemption or payment of principal of, or reduce the rate or change the time of payment or method of computation of interest on, the Notes, (ii) change the percentage of the principal amount of the Notes the holders of which are required to consent to any such amendment or waiver, or
(iii) amend any of Sections 8, 12(a), 12(b), 13, 17 or 20 hereof.

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17.2. SOLICITATION OF HOLDERS OF NOTES.

(a) Solicitation. The Company will provide each holder of the Notes (irrespective of the amount of Notes then owned by it) with the same information provided to any other holders with respect to any proposed amendment, waiver or consent in respect of any of the provisions hereof or of the Notes. The Company will deliver executed or true and correct copies of each amendment, waiver or consent effected pursuant to the provisions of this Section 17 to each holder of outstanding Notes promptly following the date on which it is executed and delivered by, or receives the consent or approval of, the requisite holders of Notes.

(b) Payment. The Company will not directly or indirectly pay or cause to be paid any remuneration, whether by way of supplemental or additional interest, fee or otherwise, or grant any security, to any holder of Notes as consideration for or as an inducement to the entering into by any holder of Notes or any waiver or amendment of any of the terms and provisions hereof or of the Notes, unless such remuneration is concurrently offered (and paid if accepted) or paid, or security is concurrently offered (and granted if accepted) or granted, on the same terms, ratably to each holder of Notes then outstanding even if such holder did not consent to such waiver or amendment.

17.3. BINDING EFFECT, ETC.

Any amendment or waiver consented to as provided in this Section 17 applies equally to all holders of Notes and is binding upon them and upon each future holder of any Note and upon the Company without regard to whether such Note has been marked to indicate such amendment or waiver. No such amendment or waiver will extend to or affect any obligation, covenant, agreement, Default or Event of Default not expressly amended or waived or impair any right consequent thereon. No course of dealing between the Company and the holder of any Note and no delay in exercising any rights hereunder or under any Note shall operate as a waiver of any rights of any holder of such Note.

17.4. NOTES HELD BY COMPANY, ETC.

Solely for the purpose of determining whether the holders of the requisite percentage of the aggregate principal amount of Notes then outstanding approved or consented to any amendment, waiver or consent to be given under this Agreement or the Notes, or have directed the taking of any action provided herein or in the Notes to be taken upon the direction of the holders of a specified percentage of the aggregate principal amount of Notes then outstanding, Notes directly or indirectly owned by the Company or any of its Affiliates shall be deemed not to be outstanding.

17.5. CONSENT OF MAJORITY HOLDERS.

Whenever consent of the holders of Notes is required by this Agreement, the Company will request the consent of such holders through written notice to each holder of

25

record. The Company may engage the services of a third party in order to assist the Company to obtain consent of said holders of the Notes.

18. NOTICES.

All notices and communications provided for hereunder shall be in writing and sent either by (a) telecopy if the sender on the same day sends a confirming copy of such notice by a recognized overnight delivery service (charges prepaid), (b) registered or certified mail with return receipt requested (postage prepaid), or (c) a recognized overnight delivery service (with charges prepaid). Any such notice must be sent:

(a) if to you or your nominee, to you or it at the address specified for such communications in Schedule A, or at such other address as you or it shall have specified to the Company in writing,

(b) if to any other holder of any Note, to such holder at such address as such other holder shall have specified to the Company in writing, or

(c) if to the Company, to the Company at 1441 F. D. Roosevelt Avenue, Sixth Floor, San Juan, Puerto Rico 00920, Attention: Chief Financial Officer, or at such other address as the Company shall have specified to the holder of each Note in writing.

Notices under this Section 18 will be deemed given only when actually received.

19. REPRODUCTION OF DOCUMENTS.

This Agreement and all documents relating thereto, including, without limitation, (a) consents, waivers and modifications that may hereafter be executed, (b) documents received by you at the Closing (except the Notes themselves), and (c) financial statements, certificates and other information previously or hereafter furnished to you, may be reproduced by you by any photographic, photostatic, microfilm, microcard, miniature photographic or other similar process and you may destroy any original document so reproduced. The Company agrees and stipulates that, to the extent permitted by applicable law, any such reproduction shall be admissible in evidence as the original itself in any judicial or administrative proceeding (whether or not the original is in existence and whether or not such reproduction was made by you in the regular course of business) and any enlargement, facsimile or further reproduction of such reproduction shall likewise be admissible in evidence. This Section 19 shall not prohibit the Company or any other holder of Notes from contesting any such reproduction to the same extent that it could contest the original, or from introducing evidence to demonstrate the inaccuracy of any such reproduction.

20. CONFIDENTIAL INFORMATION.

For the purposes of this Section 20, "CONFIDENTIAL INFORMATION" means information delivered to you by or on behalf of the Company or any of its Affiliates in connection with the transactions contemplated by or otherwise pursuant to this Agreement that is clearly marked or labeled or otherwise adequately identified when received by you as being confidential

26

information of the Company or such Affiliate, provided that such term does not include information that (a) was publicly known or otherwise known to you prior to the time of such disclosure, (b) subsequently becomes publicly known through no act or omission by you or any person acting on your behalf or (c) otherwise becomes known to you other than through disclosure by or on behalf of the Company or any of its Affiliates or as a result of a breach of a confidentiality agreement (which breach is known to you). You will maintain the confidentiality of such Confidential Information and will not disclose it to other Persons and (except in connection with your holding of Notes and exercise of rights under the Notes or this Agreement) will not use it, provided that you may deliver or disclose Confidential Information to (i) your directors, officers, employees, agents, attorneys and affiliates (to the extent such disclosure reasonably relates to the administration of the investment represented by your Notes and provided such recipients are advised of the confidential nature of such information), (ii) your financial advisors and other professional advisors (to the extent such disclosure reasonably relates to your investment in the Notes) who agree to hold confidential the Confidential Information substantially in accordance with the terms of this Section 20, (iii) any other holder (unless known by you to be a competitor of the Company) of any Note, (iv) any Institutional Investor (unless known by you to be a competitor of the Company) to which you sell or offer to sell such Note or any part thereof or any participation therein (if such Person has agreed in writing prior to its receipt of such Confidential Information to be bound by the provisions of this Section 20), (v) any Person (unless known by you to be a competitor of the Company) from which you offer to purchase any security of the Company (if such Person has agreed in writing prior to its receipt of such Confidential Information to be bound by the provisions of this Section 20), (vi) as may be required by any federal or state regulatory authority having jurisdiction over you, (vii) as may be required by any nationally recognized rating agency that requires access to information about your investment portfolio, or (viii) any other Person to which such delivery or disclosure may be necessary (w) to effect compliance with any law, rule, regulation or order applicable to you, (x) in response to any subpoena or other legal process, (y) in connection with any litigation to which you are a party or (z) if an Event of Default has occurred and is continuing, to the extent you may reasonably determine such delivery and disclosure to be necessary in the enforcement or for the protection of the rights and remedies under your Notes and this Agreement. Each holder of a Note, by its acceptance of a Note, will be deemed to have agreed to be bound by and to be entitled to the benefits of this Section 20 as though it were a party to this Agreement. Without limiting the foregoing, on reasonable request by the Company in connection with the delivery to any holder of a Note of information required to be delivered to such holder under this Agreement or requested by such holder under this Agreement, such holder will enter into a separate agreement with the Company embodying and confirming the provisions of this Section 20.

21. MISCELLANEOUS.

21.1. SUCCESSORS AND ASSIGNS.

All covenants and other agreements contained in this Agreement by or on behalf of any of the parties hereto bind and inure to the benefit of their respective successors and assigns (including, without limitation, any subsequent holder of a Note) whether so expressed or not.

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21.2. PAYMENTS DUE ON NON-BUSINESS DAYS.

Anything in this Agreement or the Notes to the contrary notwithstanding, any payment of principal of or interest on any Note that is due on a date other than a Business Day shall be made on the next succeeding Business Day without including the additional days elapsed in the computation of the interest payable on such next succeeding Business Day.

21.3. SEVERABILITY.

Any provision of this Agreement that is prohibited or unenforceable in any jurisdiction shall, as to such jurisdiction, be ineffective to the extent of such prohibition or unenforceability without invalidating the remaining provisions hereof, and any such prohibition or unenforceability in any jurisdiction shall (to the full extent permitted by law) not invalidate or render unenforceable such provision in any other jurisdiction.

21.4. CONSTRUCTION.

Each covenant contained herein shall be construed (absent express provision to the contrary) as being independent of each other covenant contained herein, so that compliance with any one covenant shall not (absent such an express contrary provision) be deemed to excuse compliance with any other covenant. Where any provision herein refers to action to be taken by any Person, which action such Person is prohibited from taking, such provision shall be applicable whether such action is taken by such Person or on such Person's behalf. Titles and headings of the sections of this Agreement appear as a matter of convenience only and shall not affect the construction hereof. The words "HEREIN," "HEREOF," "HEREUNDER" and "HERETO" refer to this Agreement as a whole. The term "INCLUDING" means "INCLUDING WITHOUT LIMITATION" whether or not so expressed. All currencies used herein are U.S. dollars.

21.5. COUNTERPARTS.

This Agreement may be executed in any number of counterparts, each of which shall be deemed an original but all of which together shall constitute one instrument. Each counterpart may consist of a number of copies hereof, each signed by less than all, but together signed by all, of the parties hereto.

21.6. GOVERNING LAW.

This Agreement shall be construed and enforced in accordance with, and the rights of the parties shall be governed by, the law of the Commonwealth of Puerto Rico without giving effect to any principles of conflicts of law which might make the laws of any other jurisdiction applicable.

* * * * *

If you are in agreement with the foregoing, please so indicate by signing the acceptance on the accompanying counterpart of this Agreement and return it to the Company, whereupon this Agreement shall become a binding agreement among you and the Company.

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Very truly yours,

TRIPLE-S MANAGEMENT CORPORATION


Juan Jose Roman, CPA Vice President of Finance and Chief Financial Officer

The foregoing is hereby agreed to as
of the date thereof:

PUERTO RICO FIXED INCOME FUND IV, INC.
PUERTO RICO AAA PORTFOLIO TARGET
MATURITY FUND, INC.

By:
Name: Ricardo Ramos
Title: First Vice President

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SCHEDULE A

INFORMATION RELATING TO PURCHASERS

                                                           Principal Amount of
Name and Address of Purchasers                            Notes to be Purchased
------------------------------                            ---------------------
1. Puerto Rico Fixed Income Fund IV, Inc.                     $20,000,000.00

2. Puerto Rico AAA Portfolio Target Maturity Fund, Inc.       $15,000,000.00

All payments by wire transfer of immediately available funds to:

Citibank, NYC
ABA 021000089

For further credit to each Purchaser's DDA account specified below:

1. Puerto Rico Fixed Income Fund IV, Inc. DDA Account Number 36245157

2. Puerto Rico AAA Portfolio Target Maturity Fund, Inc. DDA Account Number 36205278

with sufficient information to identify the source and application of such funds.

All notices of payments and written confirmations of such wire transfers

UBS Trust Company of Puerto Rico
Attn: Claudio D. Ballester
American International Plaza, 10th Floor 250 Munoz Rivera Avenue
San Juan, PR 00918

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All other communications:

UBS Trust Company of Puerto Rico
Attn: Claudio D. Ballester
American International Plaza, 10th Floor 250 Munoz Rivera Avenue
San Juan, PR 00918

Telephone: (787) 250-3629
Telefax: (787) 250-5797

Notes are to be delivered to:

1. One Citibank Drive PL Sur, Lomas Verde Avenue San Juan, PR 00926 Account Number 0/425589/296

2. One Citibank Drive PL Sur, Lomas Verde Avenue San Juan, PR 00926 Account Number 0/425589/075

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SCHEDULE B

DEFINED TERMS

As used herein, the following terms have the respective meanings set forth below or set forth in the section hereof following such term:

"AFFILIATE" means, at any time, and with respect to any Person, any other Person that at such time directly or indirectly through one or more intermediaries Controls, or is Controlled by, or is under common Control with, such first Person. Unless the context otherwise clearly requires, any reference to an "AFFILIATE" is a reference to an Affiliate of the Company.

"ANTI-MONEY LAUNDERING LAWS" means all applicable laws, rules, regulations and other requirements relating to applicable anti-money laundering rules, including the USA Patriot Act of 2001 (the "PATRIOT ACT"), the regulations administered by the U.S. Department of Treasury's Office of Foreign Assets Control thereunder and other applicable U.S. and non-U.S. anti-money laundering laws, statutes, regulations and internal rules in connection therewith.

"BUSINESS DAY" means any day other than a Saturday, a Sunday or a day on which commercial banks in San Juan, Puerto Rico are required or authorized to be closed.

"CLOSING" is defined in Section 3.

"CODE" means the Internal Revenue Code of 1986 and the rules and regulations promulgated thereunder as in effect on the Closing.

"COMPANY" means Triple-S Management Corporation, a Puerto Rico corporation.

"CONFIDENTIAL INFORMATION" is defined in Section 20.

"CONTROL" (and the correlative terms thereof) means the possession, directly or indirectly, of the power to direct or cause the direction of the management and policies of a Person, whether through the ownership of voting securities, by contract or otherwise.

"DEFAULT" means an event or condition the occurrence or existence of which would, with the lapse of time or the giving of notice or both, become an Event of Default.

"DEFAULT RATE" means that rate of interest that is the greater of (i) two percent (2%) per annum above the rate of interest stated in clause (a) of the first paragraph of the Notes or (ii) two percent (2%) over the rate of interest publicly announced from time to time by Citibank, N.A. in New York City as its "BASE" or "PRIME" rate for U.S. dollar commercial loans.

"ENVIRONMENTAL LAWS" means any and all federal, state, local, and foreign statutes, laws, regulations, ordinances, rules, judgments, orders, decrees, permits, concessions, grants, franchises, licenses, agreements or governmental restrictions relating to pollution and the

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protection of the environment or the release of any materials into the environment, including but not limited to those related to hazardous substances or wastes, air emissions and discharges to waste or public systems.

"ERISA" means the Employee Retirement Income Security Act of 1974, as amended from time to time, and the rules and regulations promulgated thereunder from time to time in effect.

"ERISA AFFILIATE" means any trade or business (whether or not incorporated) that is treated as a single employer together with the Company under section 210 of ERISA.

"EVENT OF DEFAULT" is defined in Section 12.

"EXCHANGE ACT" is defined in Section 7.1(a).

"GAAP" means generally accepted accounting principles as in effect from time to time in the United States of America.

"GOVERNMENTAL AUTHORITY" means

(a) the government of

(i) the United States of America, the Commonwealth of Puerto Rico or any State of the United States or other political subdivision thereof, or

(ii) any jurisdiction in which the Company or any of its Subsidiaries conducts all or any part of its business, or which asserts jurisdiction over any properties of the Company or any of its Subsidiaries, or

(b) any entity exercising executive, legislative, judicial, regulatory or administrative functions of, or pertaining to, any such government.

"GROUP MEMBER" shall mean the Company and each of its Subsidiaries.

"HOLDER" means, with respect to any Note, the Person in whose name such Note is registered in the register maintained by the Company pursuant to
Section 14.1.

"INDEBTEDNESS FOR BORROWED MONEY" means any obligation (whether present or future or secured or unsecured) for the payment or repayment of money borrowed or raised (whether or not for a cash consideration), by whatever means (including deposits and financial leasing or under or pursuant to any letter of credit (once such letter of credit shall have been drawn upon) to secure financial accommodation, promissory note, certificate of deposit or like instrument (whether negotiable or otherwise) or any acceptance credit facility, note purchase facility or bill acceptance or discounting facility or like arrangement entered into) by any Person in order to enable it to finance its operations or capital requirements; it being acknowledged that reimbursement obligations in respect of advance payments made by or on behalf of third party

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customers in relation to purchase orders to the Company are not "INDEBTEDNESS
FOR BORROWED MONEY."

"INSTITUTIONAL INVESTOR" means (a) any original purchaser of a Note and (b) any bank, trust company, savings and loan association or other financial institution, any pension plan, any investment company, any insurance company, any broker or dealer, trust, corporation, partnership or any other similar financial institution or entity, regardless of legal form that is an "accredited investor" as defined in Rule 501(a) under the Securities Act; provided, however, that any investment company licensed under the laws of the Commonwealth of Puerto Rico and exempt from registration under the Investment Company Act of 1940 which otherwise meets the criteria of an "accredited investor" under Rule
501(a), shall qualify as an "INSTITUTIONAL INVESTOR".

"LIEN" means any mortgage, pledge, lien, hypothecation, prior claim, security interest or other charge or encumbrance and any deferred purchase, sale-and-purchase or sale-and-leaseback arrangement and any other arrangement of a like or similar effect.

"MAJORITY HOLDERS" means the holders of Notes representing in the aggregate a majority in aggregate outstanding principal amount of the Notes.

"MATERIAL" means, with respect to any Person, material in relation to the business, operations or condition (financial or otherwise) of such Person and its Subsidiaries taken as a whole; provided that for purposes of this Agreement, any amount or obligation shall be deemed to be "material" if it equals or exceeds 10% of the Company's consolidated stockholder's equity, as set forth in the most recent annual or quarterly financial statements of the Company filed with the SEC or otherwise delivered to the holders of the Notes.

"MATERIAL ADVERSE EFFECT" means a material adverse effect on (a) the business, operations or condition (financial or otherwise) of the Company and its Subsidiaries taken as a whole, or (b) the ability of the Company to perform its obligations under this Agreement or the Notes, or (c) the validity or enforceability against the Company of this Agreement or the Notes.

"MULTIEMPLOYER PLAN" means any Plan that is a "MULTIEMPLOYER PLAN" (as such term is defined in section 4001(a)(3) of ERISA).

"NOTES" is defined in Section 1.

"OFFICER'S CERTIFICATE" means, with respect to any Person, a certificate of a Senior Financial Officer or of any other officer of such Person whose responsibilities extend to the subject matter of such certificate.

"OPINION OF COUNSEL" means a written opinion of counsel from legal counsel who is acceptable to the Majority Holders. The counsel may be an employee of, or external counsel to the Company.

"PERSON" means an individual, partnership, corporation, limited liability company, association, trust, unincorporated organization or a government or agency or political subdivision thereof.

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"PLAN" means an "EMPLOYEE BENEFIT PLAN" (as defined in section 3(3) of ERISA) that is or, within the preceding five years, has been established or maintained, or to which contributions are or, within the preceding five years, have been made or required to be made, by the Company or any ERISA Affiliate or with respect to which the Company or any ERISA Affiliate may have any liability.

"PRINCIPAL INSURANCE SUBSIDIARY" means Triple-S, Inc. and its successors and assigns.

"PRIRC" means the Puerto Rico Internal Revenue Code of 1994, as amended.

"PROPERTY" or "PROPERTIES" means, unless otherwise specifically limited, real or personal property of any kind, tangible or intangible, choate or inchoate.

"PRUSA" is defined in Section 6.1(a).

"PURCHASERS" means the Persons named as such in Schedule A of this Agreement.

"QPAM EXEMPTION" means Prohibited Transaction Class Exemption 84-14 issued by the United States Department of Labor.

"REDEMPTION DATE" is defined in Section 9.1.

"RESPONSIBLE OFFICER" means any Senior Financial Officer and any other officer of the Company with responsibility for the administration of the relevant portion of this agreement.

"RISK-BASED CAPITAL RATIO" ("RBC") means the Risk-based capital ratio of the Company computed in accordance with the formula promulgated by the National Association of Insurance Commissioners to measure the amount of capital required from time to time to support the consolidated business operations of holding companies principally engaged in the business of the Company, considering, among others, the size of its assets, risk profile and reserve items.

"SEC" is defined in Section 7.1(a).

"SECURITIES ACT" means the Securities Act of 1933, as amended from time to time.

"SENIOR FINANCIAL OFFICER" means the chief financial officer, principal accounting officer, treasurer or comptroller of any Person.

"SIGNIFICANT SUBSIDIARY" means any Subsidiary (including its Subsidiaries) of the Company which (1) is principally engaged in (a) the healthcare and medical insurance business as an insurance company or a health maintenance organization, (b) the property and casualty insurance business, or
(c) the life insurance business, and (2) meets any of the following conditions:
(i) the Company's and its other Subsidiaries' investments in and advances to the Subsidiary exceed 20 percent of the total assets of the Company and its Subsidiaries consolidated

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as of the end of the most recently completed fiscal year; (ii) the Company's and its other Subsidiaries' proportionate share of the total assets (after intercompany eliminations) of the Subsidiary exceeds 20 percent of the total assets of the Company and its Subsidiaries consolidated as of the end of the most recently completed fiscal year; or (iii) the Company's and its other Subsidiaries' equity in the income from continuing operations before income taxes, extraordinary items and cumulative effect of a change in accounting principles of the Subsidiary exceeds 20 percent of such income of the Company and its Subsidiaries consolidated as of the end of the most recently completed fiscal year; provided, however, that for purposes of paragraphs (h) and (i) of
Section 12 hereof, the term "SIGNIFICANT SUBSIDIARY" shall mean any Subsidiary of the Company which generates gross revenues in an amount that exceeds 20 percent of the consolidated gross revenues of the Company and its Subsidiaries consolidated as of the end of the most recently completed fiscal year.

"SUBSIDIARY" means with respect to any Person, any other Person more than fifty percent of whose stock or other equity interest of any class or classes having by the terms thereof ordinary voting power to elect a majority of the directors (or equivalent officials) of such other Person (irrespective of whether or not at the time stock or other equity interests of any class or classes of such other Person shall have or might have voting power by reason of the happening of any contingency) is at the time owned by such Person, directly or indirectly through Subsidiaries. Unless the context otherwise clearly requires, any reference to a "SUBSIDIARY" is a reference to a Subsidiary of the Company.

"TREASURY" means the Puerto Rico Treasury Department.

"WHOLLY OWNED SUBSIDIARY" means a Subsidiary of which all of the outstanding voting stock (other than directors' qualifying shares) is at the time, directly or indirectly, owned by the Company, or by one or more wholly owned Subsidiaries of the Company or by the Company and one or more wholly owned Subsidiaries of the Company.

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SCHEDULE 5.3

Financial Statements of the Company

Audited Consolidated Financial Statements for the Company for the fiscal year ended on December 31, 2004 and Non-Audited Consolidated Financial Statements for the Company for the quarter ended on September 30, 2005.

Sch 5.3-1


SCHEDULE 5.6

Litigation

(i) Drs. Carlyle Benavent and Ibrahim Perez (the plaintiffs) caused the initiation of an administrative proceeding before the Puerto Rico Commissioner of Insurance (the "Commissioner") against the Company and Triple-S, Inc. ("TSI"), one of its wholly owned subsidiaries, alleging the illegality of the repurchase and subsequent sale of 1,582 shares of TSI's common stock due to the fact that the ultimate purchasers of said shares were selected on an improper and selective basis by the Company in violation of the Puerto Rico Insurance Code. The plaintiffs alleged that they were illegally excluded from participation in the sale of shares by TSI due to the illegally selective nature of the sale of shares and that, consequently the sale of shares should be eliminated.

On December 1996, the Commissioner issued an order to annul the sale of the 1,582 shares that TSI had repurchased from the estate of deceased stockholders. TSI contested such orders through an administrative and judicial review process. Consequently, the sale of 1,582 shares was cancelled and the purchase price was returned to each former stockholder. In the year 2000, the Commissioner issued a pronouncement providing further clarification of the content and effect of the order. This order also required that all corporate decisions undertaken by TSI through the vote of its stockholders of record, be ratified in a stockholders' meeting or in a subsequent referendum. In November 2000, the Company, as the sole stockholder of TSI, ratified all such decisions. Furthermore, on November 19, 2000, the Company held a special stockholders' meeting, where a ratification of these decisions was undertaken except for the resolution related to the approval of the reorganization of TSI and its subsidiaries. This resolution did not reach the two thirds majority required by the order because the number of shares that were present and represented at the meeting was below such amount (total shares present and represented in the stockholders' meeting was 64%). As stipulated in the order, the Company began the process to conduct a referendum among its stockholders in order to ratify such resolution. The process was later suspended because upon further review of the scope of the order, the Commissioner issued an opinion in a letter dated January 8, 2002 which indicated that the ratification of the corporate reorganization was not required.

In another letter dated March 14, 2002, the Commissioner stated that the ratification of the corporate reorganization was not required and that TSI had complied with the Commissioner's order of December 6, 1996 related to the corporate reorganization. Thereafter, the plaintiffs filed a petition for review of the Commissioner's determination before the Puerto Rico Circuit Court of Appeals. Such petition was opposed by TSI and by the Commissioner.

Pursuant to that review, on September 24, 2002, the Puerto Rico Circuit Court of Appeals issued an order requiring the Commissioner to order a meeting of stockholders to ratify TSI's corporate reorganization and the change of name of TSI from Seguros de Servicio de Salud de Puerto Rico, Inc. to Triple-S, Inc. The Puerto Rico Circuit Court of Appeals

Sch 5.6-1


based its decision on administrative and procedural issues directed at the Commissioner. The Commissioner filed a motion of reconsideration with the Puerto Rico Circuit Court of Appeals on October 11, 2002. TSI and the Company also filed a motion of reconsideration.

On October 25, 2002, the Puerto Rico Circuit Court of Appeals dismissed the Commissioner's Motion for Reconsideration and ordered the plaintiffs to reply to TSI's and the Company's Motion of Reconsideration.

On May 18, 2003, the Puerto Rico Circuit Court of Appeals granted TSI's and the Company's Motion of Reconsideration. The Puerto Rico Circuit Court of Appeals held that the Commissioner had the authority to waive the celebration of a referendum to ratify TSI's reorganization and that therefore the reorganization of TSI, inasmuch as the 1,582 shares annulled were not decisive, was approved by the stockholders.

On June 26, 2003, the two stockholders presented a writ of certiorari before the Supreme Court of Puerto Rico. TSI and the Company filed a motion opposing the issuance of the writ. The writ was issued by the Supreme Court on August 22, 2003, when it ordered the Puerto Rico Circuit Court of Appeals to transmit the record of the case. On December 1, 2003, the plaintiffs filed a motion submitting their case on the basis of their original petition. TSI and the Company filed its brief on December 30, 2003, while the Commissioner, in turn, filed a separate brief on December 31, 2003. On June 24, 2004 the Supreme Court ordered the plaintiffs to file a brief in support of their allegations. The case is still pending before the Supreme Court of Puerto Rico. It is the opinion of management that the corporate reorganization as approved is in full force and effect.

(ii) On September 4, 2003, Jose Sanchez and others filed a putative class action complaint against the Company, present and former directors of the Company and TSI, and others, in the United States District Court for the District of Puerto Rico, alleging violations under the Racketeer Influenced and Corrupt Organizations Act, better known as the RICO Act. The suit, among other allegations, alleges a scheme to defraud the plaintiffs by acquiring control of TSI through illegally capitalizing TSI and later converting it to a for-profit corporation and depriving the stockholders of their ownership rights. The plaintiffs base their later allegations on the supposed decisions of TSI's board of directors and stockholders, allegedly made in 1979, to operate with certain restrictions in order to turn TSI into a charitable corporation, basically forever. On March 4, 2005 the Court issued an Opinion and Order. In this Opinion and Order, of the twelve counts included in the complaint, eight counts were dismissed for failing to assert an actionable injury; six of them for lack of standing and two for failing to plead with sufficient particularity in compliance with the Rules. All shareholder allegations, including those described above, were dismissed in the Opinion and Order. The remaining four counts were found standing, in a limited way, in the Opinion and Order. Finally, the Court ordered that by March 24, 2005 one of the counts left standing be replead to conform to the Rules and that by March 28, 2005 a proposed schedule for discovery and other submissions be filed. The count was amended and accepted by the Court, the discovery schedule was submitted. The parties just finished class certification discovery. On

Sch 5.6-2


November 30, 2005, Plaintiffs filed their briefs in support of their request for class certification. Defendants filed their opposition on December 14, 2005. This case is still pending before the United States District Court for the District of Puerto Rico.

(iii) On April 24, 2002, Octavio Jordan, Agripino Lugo, Ramon Vidal, and others filed a suit against the Company, TSI and others in the Court of First Instance for San Juan, Superior Section, alleging, among other things, violations by the defendants of provisions of the Puerto Rico Insurance Code, practices, unfair business practices and damages in the amount of $12.0 million. They also requested that the Company sell shares to them. After a preliminary review of the complaint, it appears that many of the allegations brought by the plaintiffs have been resolved in favor of the Company and TSI in previous cases brought by the same plaintiffs in the United States District Court for the District of Puerto Rico and by most of the plaintiffs in the local courts. The defendants, including the Company and TSI answered the complaint, filed a counterclaim and filed several motions to dismiss this claim. On February 18, 2005 the plaintiffs informed their intention to amend the complaint and the Court granted then 45 days to do so and 90 days to defendants to file the corresponding motion to dismiss. On May 9, 2005 the plaintiffs filed the amended complaint and defendants are preparing the corresponding motions to dismiss this amended complaint. The plaintiffs amended the complaint to allege similar causes of action dismissed by the United States District Court for the District of Puerto Rico in the Sanchez case. Defendants moved to dismiss the amended complaint. Plaintiffs have notified their opposition to some of the defendants' motions to dismiss. Defendants will reply once the oppositions to all of the defendant's motions are notified.

(iv) On May 22, 2003 a putative class action suit was filed by Kenneth A. Thomas, M.D. and Michael Kutell, M.D., on behalf of themselves and all other similarly situated and the Connecticut State Medical Society against the Blue Cross and Blue Shield Association ("BCBSA") and multiple other insurance companies, including TSI. The case is pending before the United States District Court for the Southern District of Florida, Miami District.

The individual plaintiffs bring this action on behalf of themselves and a class of similarly situated physicians seeking redress for alleged illegal acts of the defendants which they allege have resulted in a loss of their property and a detriment to their business, and for declaratory and injunctive relief to end those practices and prevent further losses. Plaintiffs alleged that the defendants, on their own and as part of a common scheme, systematically deny, delay and diminish the payments due to doctors so that they are not paid in a timely manner for the covered, medically necessary services they render.

The class action complaint alleges that the health care plans are the agents of BCBSA licensed entities, and as such have committed the acts alleged above and acted within the scope of their agency, with the consent, permission, authorization and knowledge of the others, and in furtherance of both their interest and the interests of other defendants.

Management believes that TSI was brought to this litigation for the sole reason of being associated with BCBSA. However, on June 18, 2004, the plaintiffs moved to amend the

Sch 5.6-3


complaint to include the Colegio de Medicos Cirujanos de Puerto Rico (a compulsory association grouping all physicians in Puerto Rico), Marissel Velazquez, M.D., President of Colegio de Medicos y Cirujanos de Puerto Rico, and Andres Melendez, M.D., as plaintiffs against TSI. Later, Marissel Velazquez, M.D. voluntarily dismissed her complaint against TSI.

TSI, along with the other defendants, moved to dismiss the complaint under multiple grounds, including but not limited to arbitration and applicability of the McCarran Ferguson Act.

(v) On December 8, 2003 a putative class action was filed by Jeffrey Solomon, M.D., and Orlando Armstrong, M.D., on behalf of themselves and all other similarly situated and the American Podiatric Medical Association, Florida Chiropractic Association, California Podiatric Medical Association, Florida Podiatric Medical Association, Texas Podiatric Medical Association, and Independent Chiropractic Physicians, against BCBSA and multiple other insurance companies, including TSI, all members of BCBSA. The case is still pending before the United States District Court for the Southern District of Florida, Miami District.

The individual plaintiffs bring this action on behalf of themselves and a class of similarly situated physicians seeking redress for alleged illegal acts of the defendants which are alleged to have resulted in a loss of plaintiff's property and a detriment to their business, and for declaratory and injunctive relief to end those practices and prevent further losses. Plaintiffs alleged that the defendants, on their own and as part of a common scheme, systematically deny, delay and diminish the payment due to the doctors so that they are not paid in a timely manner for the covered, medically necessary services they render.

The class action complaint alleges that the health care plans are the agents of BCBSA licensed entities, and as such have committed the acts alleged above and acted within the scope of their agency, with the consent, permission, authorization and knowledge of the others, and in furtherance of both their interest and the interests of other defendants.

On June 25, 2004, the plaintiffs amended the complaint but the allegations against TSI did not vary. TSI, along with the other defendants, moved to dismiss the complaint under multiple grounds, including but not limited to arbitration and applicability of the McCarran Ferguson Act. Management believes that TSI was made a party to this litigation for the sole reason that TSI is associated with BCBSA. TSI, along with the other defendants, moved to dismiss the complaint under multiple grounds, including but not limited to arbitration and applicability of the McCarran Ferguson Act.

Sch 5.6-4


SCHEDULE 5.8

Liens

The Company's real properties located at 1441 F.D. Roosevelt Avenue in San Juan, Puerto Rico and 1510 F.D. Roosevelt Avenue in Guaynabo, Puerto Rico are subject to a mortgage in favor of FirstBank Puerto Rico, as collateral to a credit agreement between the Company and FirstBank Puerto Rico dated as of June 29, 1999, as amended on August 30, 2001.

Sch 5.9-1


SCHEDULE 5.13

Existing Indebtedness for Borrowed Money

TRIPLE-S MANAGEMENT CORPORATION

                                                            Principal Amount
                                                           Outstanding as of
Lender                               Description             Dec. 31, 2005
------                               -----------           -----------------
FirstBank Puerto Rico       Secured Loan                      $29,500,000

FirstBank Puerto Rico       Secured Note                      $11,500,000

Santander Family of Funds   Guaranty of Triple-S, Inc.        $50,000,000
                            6.30% Senior Unsecured Notes
                            due September 2019

Santander Family of Funds   6.60% Senior Unsecured            $60,000,000
                            Notes due December 2020

TRIPLE-S, INC.

                                                                  Principal Amount
                                                                 Outstanding as of
Lender                                     Description             Dec. 31, 2005
------                                     -----------           -----------------
Triple-S Management Corporation   Surplus Note                      $26,000,000

Santander Family of Funds         Senior Unsecured Notes            $50,000,000
                                  6.30% Senior Unsecured Notes
                                  due September 2019

Sch 5.13-1


EXHIBIT 1

THIS NOTE HAS NOT BEEN REGISTERED UNDER THE SECURITIES ACT OF 1933, AS AMENDED, AND IS NOT TRANSFERABLE EXCEPT PURSUANT TO AN EXEMPTION FROM SUCH REGISTRATION AND IN ACCORDANCE WITH THE REQUIREMENTS OF THE NOTE PURCHASE AGREEMENT REFERRED TO HEREIN.

TRIPLE-S MANAGEMENT CORPORATION

6.70% SENIOR UNSECURED NOTE DUE JANUARY 2021

No. [___]                                                       January 31, 2006
US[$_____]                                                      [______________]

          FOR VALUE RECEIVED, the undersigned, TRIPLE-S MANAGEMENT CORPORATION

(herein called the "COMPANY"), a corporation organized and existing under the laws of the Commonwealth of Puerto Rico, hereby promises to pay to [___], or registered assigns, the principal sum of [_____] DOLLARS (US$_____) on January 31, 2021, with interest (computed on the basis of a 360-day year of twelve 30-day months) (a) on the unpaid balance thereof at the rate of six and seven-tenths percent (6.70%) per annum from the date hereof, payable monthly in arrears, on the first (1st) day of each month, commencing on March 1, 2006, until the principal hereof shall have become due and payable; and (b) to the extent permitted by law, on any overdue payment (including any overdue prepayment) of principal and any overdue payment of interest, payable monthly as aforesaid (or, at the option of the registered holder hereof, on demand), at a rate per annum from time to time equal to the Default Rate (as defined in the Note Purchase Agreement); provided, however, that, in the event that the Company's Risk Based Capital Ratio (as defined in the Note Purchase Agreement) is less than three hundred seventy-five percent (375%) during a period of at least one year, the interest rate payable on the principal hereof on any interest payment date after the expiration of such year shall increase to six and eighty-five tenths percent (6.85%) per annum while such condition exists.

The Company may, at its option, upon notice as provided in Section 9.1 of the Note Purchase Agreement, redeem and prepay prior to maturity from time to time, all or any part of the principal hereof on or after February 1, 2011 at a price equal to one hundred percent (100%) of the amount of principal to be redeemed together with accrued and unpaid interest, if any, to the date of redemption specified by the Company (the "REDEMPTION DATE").

The Company will give the holder of this Note written notice of any redemption under Section 9.1 of the Note Purchase Agreement not less than thirty
(30) days and not more than sixty (60) days prior to any Redemption Date.

Payments of principal with respect to this Note shall to be made in lawful money of the United States of America at the principal office of the Company in San Juan, Puerto Rico

Exh 1-1


or at such other place in Puerto Rico as the Company shall have designated by written notice to the holder of this Note as provided in the Note Purchase Agreement.

This Note is one of a series of Senior Unsecured Notes issued pursuant to the Note Purchase Agreement, dated January 23, 2006, as from time to time amended or as the terms thereof may be waived (the "NOTE PURCHASE AGREEMENT"), between the Company and the Purchasers named therein and is entitled to the benefits thereof. Each holder of this Note will be deemed, by its acceptance hereof, (i) to have agreed to the confidentiality provisions set forth in
Section 20 of the Note Purchase Agreement and (ii) to have made the representations set forth in Section 6 of the Note Purchase Agreement.

This Note is registered in a register kept at the principal executive office of the Company and, as provided in the Note Purchase Agreement, upon surrender of this Note for registration of transfer, duly endorsed, or accompanied by a written instrument of transfer duly executed by the registered holder hereof or such holder's attorney duly authorized in writing, a new Note for a like principal amount will be issued to, and registered in the name of, the transferee. Prior to due presentment for registration of transfer, the Company may treat the person in whose name this Note is registered as the owner hereof for the purpose of receiving payment and for all other purposes, and the Company will not be affected by any notice to the contrary.

If an Event of Default, as defined in the Note Purchase Agreement, occurs and is continuing, the principal of this Note may be declared or otherwise become due and payable in the manner, at the price and with the effect provided in the Note Purchase Agreement.

This Note shall be construed and enforced in accordance with, and the rights of the parties shall be governed by, the law of the Commonwealth of Puerto Rico without regard to any principles of conflicts of law which might apply the laws of any other jurisdiction.

TRIPLE-S MANAGEMENT CORPORATION

By:

Name:
Title:

Exh 1-2


EXHIBIT 2-A

Form of Opinion of Pietrantoni Mendez & Alvarez LLP

1. The Note Purchase Agreement has been duly authorized, executed and delivered by the Company and (assuming due authorization, execution and delivery thereof by the Purchasers) constitutes a valid and legally binding agreement of the Company, enforceable against the Company in accordance with its terms, except as the enforcement thereof may be limited by bankruptcy, insolvency, reorganization, moratorium or other similar laws affecting the enforcement of creditors' rights generally from time to time in effect or by general equitable principles (regardless of whether enforcement is considered in a proceeding in equity or at law).

2. The Notes have been duly authorized by the Company for offer, sale, issuance and delivery pursuant to the Note Purchase Agreement and, when issued and delivered in the manner provided for in the Note Purchase Agreement and delivered against payment of the consideration therefor provided for in the Note Purchase Agreement, will constitute valid and legally binding obligations of the Company, enforceable against the Company in accordance with their terms, except as the enforcement thereof may be limited by bankruptcy, insolvency, reorganization, moratorium or other similar laws affecting the enforcement of creditors' rights generally from time to time in effect or by general equitable principles (regardless of whether enforcement is considered in a proceeding in equity or at law).

3. No filing with, or approval, authorization, consent, license, registration, qualification, order or decree of, any court or governmental authority or agency, domestic or foreign, is necessary or required for the due authorization, execution and delivery by the Company of the Note Purchase Agreement and the Notes or for the performance by the Company of the transactions contemplated in the Note Purchase Agreement, except such as have been previously made, obtained or rendered, as applicable.

Exh 2-A-1


EXHIBIT 2-B

Form of Opinion of Enrique R. Ubarri Baragano

1 The Company, and each of its Significant Subsidiaries, has been duly organized and is validly existing as a corporation under the laws of the Commonwealth of Puerto Rico and is in good standing with the Commonwealth of Puerto Rico.

2. The Company, and each of its Significant Subsidiaries, has the corporate power and authority to own and operate its property, to lease the property it operates as lessee and to conduct the business in which it is currently engaged.

3. The Note Purchase Agreement and the Notes have been duly authorized by all necessary corporate action on the part of the Company, and constitute legal, valid and binding obligations of the Company (assuming, with respect to the Note Purchase Agreement and any Notes issued to a Purchaser, the due authorization, execution and delivery of the Note Purchase Agreement by such Purchaser), enforceable against the Company in accordance with their terms, except as such enforceability may be limited by (i) applicable bankruptcy, insolvency, reorganization, moratorium or other similar laws affecting the enforcement of creditors' rights generally from time to time in effect and (ii) the application of equitable principles and the availability of equitable remedies.

4. The execution, delivery and performance by the Company of the Note Purchase Agreement and the Notes do not and will not (i) in any material respect contravene, result in any breach of, constitute a default under, require the consent of any party or result in the creation of any Lien in respect of any property of the Company or any of its Subsidiaries under the articles of incorporation or by-laws of the Company or any of its Subsidiaries, or any indenture, mortgage, deed of trust, loan, purchase or credit agreement, lease or any other material agreement or instrument to which the Company or any of its Subsidiaries is bound or by which their properties may be bound or affected, (ii) contravene, result in any breach of or constitute a default under an agreement with any Governmental Authority, (iii) conflict with or result in a breach or violation of any of the terms, conditions or provisions of any order, judgment, decree or ruling of any court, arbitrator or Governmental Authority applicable to the Company or any of its Subsidiaries, or (iv) violate any provision of any statute or other rule or regulation of any Governmental Authority applicable to the Company or any of its Subsidiaries.

5. To the best of your knowledge and information, the conduct of the respective businesses of the Company and its Subsidiaries is not in violation of any federal, state or local statute, administrative regulation or other law, which violation is likely to have a material adverse effect on the Company and its Subsidiaries, taken as a whole; and the Company and its Significant Subsidiaries have obtained all material licenses as are necessary or required for the conduct of their businesses as presently conducted.

6. To the best of your knowledge and information, except as disclosed in Schedule 5.6 of the Note Purchase Agreement, there are no actions, suits or proceedings pending or

Exh 2-B-1


threatened against or affecting the Company, any of its Subsidiaries or any of their properties, in any court or before any arbitrator or administrative agency of any kind or before or by any Governmental Authority that, if determined adversely to the Company or any of its Subsidiaries, individually or in the aggregate, would reasonably be expected to have a material adverse effect on the Company and its Subsidiaries, taken as a whole, and no order, judgment, decree or ruling, which could reasonably be expected to have such a material adverse effect, has been issued against the Company or any of its Subsidiaries by any court, arbitrator or Governmental Authority.

Exh 2-B-2


EXHIBIT 3

ELECTION FOR NO INCOME TAX WITHHOLDING

The undersigned hereby requests that no Puerto Rico income tax withholding be made on his/her/its interest payments on the Notes. The undersigned certifies that he/she/it is either:

- Individual resident of Puerto Rico or Puerto Rico corporation electing out of the income tax withholding;

- United States citizen not resident of Puerto Rico not subject to Puerto Rico income taxation;

- Individual not citizen of the United States and not resident of Puerto Rico not subject to Puerto Rico income taxation;

- Corporation or partnership organized outside Puerto Rico not engaged in trade or business in Puerto Rico not subject to Puerto Rico income taxation;

- A tax exemption entity not subject to Puerto Rico income taxation:


_________________ (specify); or

- Other: _________________ (specify)

Very truly yours,

By:
Name:
Title:*
Company:*


* Applicable only to legal entities.

Exh 3-1


EXHIBIT 31.1

CERTIFICATION

I, Ramon M. Ruiz-Comas, certify that:

1. I have reviewed this quarterly report on Form 10-Q of Triple-S Management Corporation;

2. Based on my knowledge, this report does not contain any untrue statement of a material fact or omit to state a material fact necessary to make the statements made, in light of the circumstances under which such statements were made, not misleading with respect to the period covered by this report;

3. Based on my knowledge, the financial statements, and other financial information included in this report, fairly present in all material respects the financial condition, results of operations and cash flows of the registrant as of, and for, the periods presented in this report;

4. The registrant's other certifying officers and I are responsible for establishing and maintaining disclosure controls and procedures (as defined in Exchange Act Rules 13a-15(e) and 15d-15(e)) for the registrant and have:

a) Designed such disclosure controls and procedures, or caused such disclosure controls and procedures to be designed under our supervision, to ensure that material information relating to the registrant, including its consolidated subsidiaries, is made known to us by others within those entities, particularly during the period in which this report is being prepared;

b) Evaluated the effectiveness of the registrant's disclosure controls and procedures and presented in this report our conclusions about the effectiveness of the disclosure controls and procedures, as of the end of the period covered by this report based on such evaluation; and

c) Disclosed in this report any change in the registrant's internal control over financial reporting that occurred during the registrant's most recent fiscal quarter that has materially affected, or is reasonably likely to materially affect, the registrant's internal control over financial reporting; and

5. The registrant's other certifying officers and I have disclosed, based on our most recent evaluation of internal control over financial reporting, to the registrant's auditors and the audit committee of the registrant's board of directors (or persons performing the equivalent functions):

a) All significant deficiencies and material weaknesses in the design or operation of internal control over financial reporting which are reasonably likely to adversely affect the registrant's ability to record, process, summarize and report financial information; and

b) Any fraud, whether or not material, that involves management or other employees who have a significant role in the registrant's internal controls over financial reporting.

Date: May 12, 2006                       By:  /s/ Ramon M. Ruiz-Comas
                                              ---------------------------------
                                              Ramon M. Ruiz-Comas
                                              President and
                                              Chief Executive Officer


EXHIBIT 31.2

CERTIFICATION

I, Juan J. Roman, certify that:

1. I have reviewed this quarterly report on Form 10-Q of Triple-S Management Corporation;

2. Based on my knowledge, this report does not contain any untrue statement of a material fact or omit to state a material fact necessary to make the statements made, in light of the circumstances under which such statements were made, not misleading with respect to the period covered by this report;

3. Based on my knowledge, the financial statements, and other financial information included in this report, fairly present in all material respects the financial condition, results of operations and cash flows of the registrant as of, and for, the periods presented in this report;

4. The registrant's other certifying officers and I are responsible for establishing and maintaining disclosure controls and procedures (as defined in Exchange Act Rules 13a-15(e) and 15d-15(e)) for the registrant and have:

a) Designed such disclosure controls and procedures, or caused such disclosure controls and procedures to be designed under our supervision, to ensure that material information relating to the registrant, including its consolidated subsidiaries, is made known to us by others within those entities, particularly during the period in which this report is being prepared;

b) Evaluated the effectiveness of the registrant's disclosure controls and procedures and presented in this report our conclusions about the effectiveness of the disclosure controls and procedures, as of the end of the period covered by this report based on such evaluation; and

c) Disclosed in this report any change in the registrant's internal control over financial reporting that occurred during the registrant's most recent fiscal quarter that has materially affected, or is reasonably likely to materially affect, the registrant's internal control over financial reporting; and

5. The registrant's other certifying officers and I have disclosed, based on our most recent evaluation of internal control over financial reporting, to the registrant's auditors and the audit committee of the registrant's board of directors (or persons performing the equivalent functions):

a) All significant deficiencies and material weaknesses in the design or operation of internal control over financial reporting which are reasonably likely to adversely affect the registrant's ability to record, process, summarize and report financial information; and

b) Any fraud, whether or not material, that involves management or other employees who have a significant role in the registrant's internal controls over financial reporting.

Date: May 12, 2006                  By:  /s/ Juan J. Roman
                                         -----------------------------------
                                         Juan J. Roman
                                         Vice President of Finance
                                         and Chief Financial Officer


EXHIBIT 32.1

CERTIFICATION

I, Ramon M. Ruiz-Comas, President and Chief Executive Officer of Triple-S Management Corporation (the Corporation), certify, pursuant to Section 906 of the Sarbanes-Oxley Act of 2002, 18 U.S.C. Section 1350, that:

1. The Quarterly Report on Form 10-Q of the Corporation for the period ended March 31, 2006 (the Report) fully complies with the requirements of Section 13(a) of the Securities and Exchange Act of 1934 (15 U.S.C. 78m) and;

2. The information contained in the Report fairly presents, in all material respects, the financial condition and results of operations of the Corporation.

Date: May 12, 2006                   By:  /s/ Ramon M. Ruiz-Comas
                                          -----------------------------------
                                          Ramon M. Ruiz-Comas
                                          President and
                                          Chief Executive Officer


EXHIBIT 32.2

CERTIFICATION

I, Juan J. Roman, Vice President of Finance and Chief Financial Officer of Triple-S Management Corporation (the Corporation), certify, pursuant to Section 906 of the Sarbanes-Oxley Act of 2002, 18 U.S.C. Section 1350, that:

1. The Quarterly Report on Form 10-Q of the Corporation for the period ended March 31, 2006 (the Report) fully complies with the requirements of Section 13(a) of the Securities and Exchange Act of 1934 (15 U.S.C. 78m) and;

2. The information contained in the Report fairly presents, in all material respects, the financial condition and results of operations of the Corporation.

Date: May 12, 2006                     By:  /s/ Juan J. Roman
                                            -----------------------------------
                                            Juan J. Roman
                                            Vice President of Finance
                                            and Chief Financial Officer