UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

FORM 10-Q
(Mark One)
QUARTERLY REPORT PURSUANT TO SECTION 13 OR 15(D) OF THE SECURITIES EXCHANGE ACT OF 1934
 
For the quarterly period ended March 31, 2017
 
Or
 
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:  001-33865
 
Triple-S Management Corporation
 
Puerto Rico
 
66-0555678
(State or other jurisdiction of incorporation or organization)
 
(I.R.S. Employer Identification No.)
     
1441 F.D. Roosevelt Avenue
San Juan, Puerto Rico
 
00920
(Address of principal executive offices)
 
(Zip code)
 
(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.
   Yes  No
 
Indicate by check mark whether the registrant has submitted electronically and posted on its corporate Web site, if any, every Interactive Data File required to be submitted and posted pursuant to Rule 405 of Regulation S-T (§232.405 of this chapter) during the preceding 12 months (or for such shorter period that the registrant was required to submit and post such files).
Yes    No
 
Indicate by check mark whether the registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer, or a smaller reporting company.  See definitions of “large accelerated filer”, “accelerated filer” and “smaller reporting company” in Rule 12b-2 of the Exchange Act.
 
Large accelerated filer 
Accelerated filer 
Non-accelerated filer 
Smaller reporting company 
 


Indicate by check mark whether the registrant is a shell company (as defined in Rule 12b-2 of the Exchange Act).  
Yes  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, 2017
Common Stock Class A, $1.00 par value
950,968
Common Stock Class B, $1.00 par value
23,491,670
 

Triple-S Management Corporation
FORM 10-Q
For the Quarter Ended March 31, 2017
 
Table of Contents
 
Part I – Financial Information
3
   
  Item 1. Financial Statements 3
       
  Item 2.  Management’s Discussion and Analysis of Financial Condition and Results of Operations 30
       
   
30
   
30
   
31
   
32
   
32
   
33
   
35
   
37
   
38
   
39
       
  Item 3. Quantitative and Qualitative Disclosures about Market Risk 41
       
  Item 4. Controls and Procedures
41
       
41
       
  Item 1. Legal Proceedings 41
       
  Item 1A. Risk Factors 41
       
  Item 2. Unregistered Sales of Equity Securities and Use of Proceeds 42
       
  Item 3. Defaults Upon Senior Securities 42
       
  Item 4. Mine Safety Disclosures 42
       
  Item 5. Other Information 42
       
  Item 6. Exhibits 42
       
43
 
2

Part I – Financial Information
 
Item 1.
Financial Statements
Triple-S Management Corporation
Condensed Consolidated Balance Sheets (Unaudited)
(dollar amounts in thousands, except share data)

   
March 31,
2017
   
December 31,
2016
 
Assets
           
Investments and cash:
           
Securities available for sale, at fair value:
           
Fixed maturities
 
$
1,153,545
   
$
1,151,643
 
Equity securities
   
277,149
     
270,349
 
Securities held to maturity, at amortized cost:
               
Fixed maturities
   
2,514
     
2,836
 
Policy loans
   
8,546
     
8,564
 
Cash and cash equivalents
   
218,884
     
103,428
 
Total investments and cash
   
1,660,638
     
1,536,820
 
Premiums and other receivables, net
   
292,837
     
286,365
 
Deferred policy acquisition costs and value of business acquired
   
195,513
     
194,787
 
Property and equipment, net
   
66,756
     
66,369
 
Deferred tax asset
   
64,128
     
57,768
 
Goodwill
   
25,397
     
25,397
 
Other assets
   
53,186
     
51,493
 
Total assets
 
$
2,358,455
   
$
2,218,999
 
Liabilities and Stockholders’ Equity
               
Claim liabilities
 
$
530,304
   
$
487,943
 
Liability for future policy benefits
   
326,162
     
321,232
 
Unearned premiums
   
163,780
     
79,310
 
Policyholder deposits
   
179,599
     
179,382
 
Liability to Federal Employees’ Health Benefits and Federal Employees’ Programs
   
37,206
     
34,370
 
Accounts payable and accrued liabilities
   
171,643
     
169,449
 
Deferred tax liability
   
19,599
     
18,850
 
Long-term borrowings
   
34,465
     
35,085
 
Liability for pension benefits
   
30,472
     
30,892
 
Total liabilities
   
1,493,230
     
1,356,513
 
Stockholders’ equity:
               
Triple-S Management Corporation stockholders’ equity
               
Common stock Class A, $1 par value. Authorized 100,000,000 shares; issued and outstanding 950,968 at March 31, 2017 and December 31, 2016, respectively
   
951
     
951
 
Common stock Class B, $1 par value. Authorized 100,000,000 shares; issued and outstanding 23,491,670 and 23,321,163 shares at March 31, 2017 and December 31, 2016, respectively
   
23,492
     
23,321
 
Additional paid-in capital
   
63,978
     
65,592
 
Retained earnings
   
726,562
     
730,904
 
Accumulated other comprehensive income
   
50,920
     
42,395
 
Total Triple-S Management Corporation stockholders’ equity
   
865,903
     
863,163
 
Non-controlling interest in consolidated subsidiary
   
(678
)
   
(677
)
Total stockholders’ equity
   
865,225
     
862,486
 
Total liabilities and stockholders’ equity
 
$
2,358,455
   
$
2,218,999
 

See accompanying notes to unaudited condensed consolidated financial statements.
 
Triple-S Management Corporation
Condensed Consolidated Statements of Earnings (Unaudited)
(dollar amounts in thousands, except per share data)

   
Three months ended
March 31,
 
   
2017
   
2016
 
Revenues:
           
Premiums earned, net
 
$
702,273
   
$
738,534
 
Administrative service fees
   
4,379
     
5,083
 
Net investment income
   
12,016
     
11,358
 
Other operating revenues
   
965
     
812
 
Total operating revenues
   
719,633
     
755,787
 
Net realized investment gains on sale of securities
   
336
     
58
 
Other income, net
   
2,525
     
875
 
Total revenues
   
722,494
     
756,720
 
Benefits and expenses:
               
Claims incurred
   
620,863
     
626,694
 
Operating expenses
   
110,946
     
122,980
 
Total operating costs
   
731,809
     
749,674
 
Interest expense
   
1,686
     
1,882
 
Total benefits and expenses
   
733,495
     
751,556
 
(Loss) income before taxes
   
(11,001
)
   
5,164
 
Income taxes
   
(6,658
)
   
1,709
 
Net (loss) income
   
(4,343
)
   
3,455
 
Less: Net loss attributable to non-controlling interest
   
1
     
1
 
Net (loss) income attributable to Triple-S Management Corporation
 
$
(4,342
)
 
$
3,456
 
Earnings per share attributable to Triple-S Management Corporation
               
Basic net (loss) income per share
 
$
(0.18
)
 
$
0.14
 
Diluted net (loss) income per share
 
$
(0.18
)
 
$
0.14
 

See accompanying notes to unaudited condensed consolidated financial statements.
 
Triple-S Management Corporation
Condensed Consolidated Statements of Comprehensive Income (Unaudited)
(dollar amounts in thousands)
   
Three months ended
March 31,
 
   
2017
   
2016
 
Net (loss) income
 
$
(4,343
)
 
$
3,455
 
Other comprehensive (loss) income, net of tax:
               
Net unrealized change in fair value of available for sale securities, net of taxes
   
8,472
     
19,577
 
Defined benefit pension plan:
               
Actuarial loss, net
   
53
     
722
 
Prior service credit, net
   
-
     
(88
)
Total other comprehensive income, net of tax
   
8,525
     
20,211
 
Comprehensive income
   
4,182
     
23,666
 
Comprehensive income attributable to non-controlling interest
   
1
     
1
 
Comprehensive income attributable to Triple-S Management Corporation
 
$
4,183
   
$
23,667
 
 
See accompanying notes to unaudited condensed consolidated financial statements.
 
Triple-S Management Corporation
Condensed Consolidated Statements of Stockholders’ Equity (Unaudited)
(dollar amounts in thousands)

   
2017
   
2016
 
Balance at January 1
 
$
863,163
   
$
847,526
 
Share-based compensation
   
(1,443
)
   
1,421
 
Repurchase and retirement of common stock
   
-
     
(8,027
)
Comprehensive income
   
4,183
     
23,667
 
Total Triple-S Management Corporation stockholders’ equity
   
865,903
     
864,587
 
Non-controlling interest in consolidated subsidiary
   
(678
)
   
(671
)
Balance at March 31
 
$
865,225
   
$
863,916
 

See accompanying notes to unaudited condensed consolidated financial statements.
 
Triple-S Management Corporation
Condensed Consolidated Statements of Cash Flows (Unaudited)
(Dollar amounts in thousands)

   
Three months ended
March 31,
 
   
2017
   
2016
 
Cash flows from operating activities:
           
Net (loss) income
 
$
(4,343
)
 
$
3,455
 
Adjustments to reconcile net income to net cash provided by operating activities:
               
Depreciation and amortization
   
2,990
     
3,700
 
Net amortization of investments
   
2,356
     
1,936
 
(Reductions) additions to the allowance for doubtful receivables
   
(3,209
)
   
1,531
 
Deferred tax benefit
   
(7,525
)
   
(2,435
)
Net realized investment gain on sale of securities
   
(336
)
   
(58
)
Interest credited to policyholder deposits
   
991
     
1,195
 
Share-based compensation
   
(1,443
)
   
1,085
 
(Increase) decrease in assets:
               
Premium and other receivables, net
   
(3,263
)
   
(35,687
)
Deferred policy acquisition costs and value of business acquired
   
(822
)
   
(685
)
Deferred taxes
   
(265
)
   
162
 
Other assets
   
(37
)
   
(26,485
)
Increase (decrease) in liabilities:
               
Claim liabilities
   
42,361
     
33,301
 
Liability for future policy benefits
   
4,930
     
17,395
 
Unearned premiums
   
84,470
     
(4,387
)
Liability to Federal Employees’ Health Benefits and Federal Employees’ Programs
   
2,836
     
1,663
 
Accounts payable and accrued liabilities
   
11,274
     
35,574
 
Net cash provided by operating activities
   
130,965
     
31,260
 
(Continued)
               
 
Triple-S Management Corporation
Condensed Consolidated Statements of Cash Flows (Unaudited)
(Dollar amounts in thousands)


   
Three months ended
March 31,
 
   
2017
   
2016
 
Cash flows from investing activities:
           
Proceeds from investments sold or matured:
           
Securities available for sale:
           
Fixed maturities sold
 
$
26,023
   
$
90,328
 
Fixed maturities matured/called
   
5,001
     
699
 
Equity securities sold
   
10,272
     
11,257
 
Securities held to maturity:
               
Fixed maturities matured/called
   
703
     
-
 
Acquisition of investments:
               
Securities available for sale:
               
Fixed maturities
   
(33,738
)
   
(118,039
)
Equity securities
   
(5,482
)
   
(92,956
)
Securities held to maturity:
               
Fixed maturities
   
(382
)
   
-
 
Increase in other investments
   
(2,044
)
   
(182
)
Net change in policy loans
   
18
     
(231
)
Net capital expenditures
   
(3,295
)
   
(1,465
)
Net cash used in investing activities
   
(2,924
)
   
(110,589
)
Cash flows from financing activities:
               
Change in outstanding checks in excess of bank balances
   
(11,401
)
   
1,916
 
Repayments of long-term borrowings
   
(24,676
)
   
(410
)
Proceeds from long-term borrowings
   
24,266
     
-
 
Repurchase and retirement of common stock
   
-
     
(8,027
)
Proceeds from policyholder deposits
   
4,116
     
3,403
 
Surrenders of policyholder deposits
   
(4,890
)
   
(2,905
)
Net cash used in financing activities
   
(12,585
)
   
(6,023
)
Net increase (decrease) in cash and cash equivalents
   
115,456
     
(85,352
)
Cash and cash equivalents:
               
Beginning of period
   
103,428
     
197,818
 
End of period
 
$
218,884
   
$
112,466
 

See accompanying notes to unaudited condensed consolidated financial statements.
 
Triple-S Management Corporation
Notes to Condensed Consolidated Financial Statements
(dollar amounts in thousands, except per share data)
(unaudited)
 
(1)
Basis of Presentation
 
The accompanying condensed consolidated interim financial statements prepared by Triple-S Management Corporation and its subsidiaries are unaudited.  In this filing, the “Corporation”, the “Company”, “TSM”, “we”, “us” and “our” refer to Triple-S Management Corporation and its subsidiaries.  The condensed consolidated interim financial statements do not include all of the information and the footnotes required by accounting principles generally accepted in the U.S. (GAAP) for complete financial statements.  These condensed 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, 2016.
 
In the opinion of management, all adjustments, consisting of a normal recurring nature necessary for a fair presentation of such condensed consolidated interim financial statements, have been included.  The results of operations for the three months ended March 31, 2017 are not necessarily indicative of the results for the full year ending December 31, 2017.
 
(2)
Recent Accounting Standards
 
On March 10, 2017, the FASB issued guidance to improve the presentation of defined benefit costs in the income statement.  In particular, the guidance requires that an employer report the service cost component in the same line item(s) as other compensation costs arising from services rendered by the pertinent employees during the period. The other components of net benefit cost are required to be presented in the income statement separately from the service cost component and outside a subtotal of income from operations, if one is presented.  Additionally, this guidance allows only the service cost component to be eligible for capitalization, when applicable (e.g., as a cost of internally manufactured inventory or a self-constructed asset).  For public companies, these amendments, which should be applied on a prospective basis, are effective for fiscal years beginning after December 15, 2017, including interim periods within those fiscal years.  Since, we do not present a subtotal of income from operations, the adoption of this guidance should not have a material impact on the presentation of the Company’s consolidated result of operations.
 
On January 26, 2017, the FASB issued guidance to simplify the manner in which an entity is required to evaluate goodwill for impairment by eliminating Step 2 from the goodwill impairment test.  Step 2 measures a goodwill impairment loss by comparing the implied fair value of a reporting unit’s goodwill with the carrying amount of that goodwill.  Instead, under the amendments in this guidance, an entity should (1) perform its annual or interim goodwill impairment test by comparing the fair value of a reporting unit with its carrying amount, and (2) recognize an impairment charge for the amount by which the carrying amount exceeds the reporting unit’s fair value, with the understanding that the loss recognized should not exceed the total amount of goodwill allocated to that reporting unit.  Additionally, this guidance removes the requirements for any reporting unit with a zero or negative carrying amount to perform a qualitative assessment and, if it fails such qualitative test, to perform Step 2 of the goodwill impairment test.  For public companies, these amendments, which should be applied on a prospective basis, are effective for fiscal years beginning after December 15, 2019, including interim periods within those fiscal years.  We are currently evaluating the impact the adoption of this guidance may have on the Company’s consolidated financial statements.
 
Other than the accounting pronouncement disclosed above, there were no other new accounting pronouncements issued during the three months ended March 31, 2017 that could have a material impact on the Corporation’s financial position, operating results or financials statement disclosures.
 
Triple-S Management Corporation
Notes to Condensed Consolidated Financial Statements
(dollar amounts in thousands, except per share data)
(unaudited)
 
(3)
Investment in Securities
 
The amortized cost for debt securities and cost for equity securities, gross unrealized gains, gross unrealized losses, and estimated fair value for available-for-sale and held-to-maturity securities by major security type and class of security at March 31, 2017 and December 31, 2016, were as follows:
 
   
March 31, 2017
 
   
Amortized
cost
   
Gross
unrealized
gains
   
Gross
unrealized
losses
   
Estimated
fair value
 
Securities available for sale:
                       
Fixed maturities:
                       
Obligations of government-sponsored enterprises
 
$
41,485
   
$
61
   
$
-
   
$
41,546
 
U.S. Treasury securities and obligations of U.S. government instrumentalities
   
72,723
     
169
     
(14
)
   
72,878
 
Obligations of the Commonwealth of Puerto Rico and its instrumentalities
   
18,248
     
857
     
(37
)
   
19,068
 
Municipal securities
   
651,091
     
34,191
     
(304
)
   
684,978
 
Corporate bonds
   
279,540
     
12,457
     
(367
)
   
291,630
 
Residential mortgage-backed securities
   
638
     
29
     
-
     
667
 
Collateralized mortgage obligations
   
42,919
     
83
     
(224
)
   
42,778
 
Total fixed maturities
   
1,106,644
     
47,847
     
(946
)
   
1,153,545
 
Equity securities - Mutual funds
   
236,356
     
40,910
     
(117
)
   
277,149
 
Total
 
$
1,343,000
   
$
88,757
   
$
(1,063
)
 
$
1,430,694
 
 
Triple-S Management Corporation
Notes to Condensed Consolidated Financial Statements
(dollar amounts in thousands, except per share data)
(unaudited)
 
   
December 31, 2016
 
   
Amortized
cost
   
Gross
unrealized
gains
   
Gross
unrealized
losses
   
Estimated
fair value
 
Securities available for sale:
                       
Fixed maturities:
                       
Obligations of government-sponsored enterprises
 
$
41,442
   
$
87
   
$
(15
)
 
$
41,514
 
U.S. Treasury securities and obligations of U.S. government instrumentalities
   
85,652
     
157
     
(9
)
   
85,800
 
Obligations of the Commonwealth of Puerto Rico and its instrumentalities
   
17,930
     
2,189
     
(68
)
   
20,051
 
Municipal securities
   
650,175
     
34,187
     
(559
)
   
683,803
 
Corporate bonds
   
263,351
     
12,182
     
(661
)
   
274,872
 
Residential mortgage-backed securities
   
684
     
34
     
-
     
718
 
Collateralized mortgage obligations
   
45,069
     
58
     
(242
)
   
44,885
 
Total fixed maturities
   
1,104,303
     
48,894
     
(1,554
)
   
1,151,643
 
Equity securities - Mutual funds
   
240,699
     
30,101
     
(451
)
   
270,349
 
Total
 
$
1,345,002
   
$
78,995
   
$
(2,005
)
 
$
1,421,992
 
 
   
March 31, 2017
 
   
Amortized
cost
   
Gross
unrealized
gains
   
Gross
unrealized
losses
   
Estimated
fair value
 
Securities held to maturity:
                       
U.S. Treasury securities and obligations of U.S. government instrumentalities
 
$
619
   
$
160
   
$
-
   
$
779
 
Residential mortgage-backed securities
   
191
     
18
     
-
     
209
 
Certificates of deposit
   
1,704
     
-
     
-
     
1,704
 
Total
 
$
2,514
   
$
178
   
$
-
   
$
2,692
 
 
Triple-S Management Corporation
Notes to Condensed Consolidated Financial Statements
(dollar amounts in thousands, except per share data)
(unaudited)
 
   
December 31, 2016
 
   
Amortized
cost
   
Gross
unrealized
gains
   
Gross
unrealized
losses
   
Estimated
fair value
 
Securities held to maturity:
                       
U.S. Treasury securities and obligations of U.S. government instrumentalities
 
$
619
   
$
158
   
$
-
   
$
777
 
Residential mortgage-backed securities
   
191
     
18
     
-
     
209
 
Certificates of deposit
   
2,026
     
-
     
-
     
2,026
 
Total
 
$
2,836
   
$
176
   
$
-
   
$
3,012
 
 
Gross unrealized losses on investment securities and the estimated fair value of the related securities, aggregated by investment category and length of time that individual securities have been in a continuous unrealized loss position as of March 31, 2017 and December 31, 2016 were as follows:

   
March 31, 2017
 
   
Less than 12 months
   
12 months or longer
   
Total
 
 
Estimated
Fair Value
   
Gross
Unrealized
Loss
   
Number of
Securities
   
Estimated
Fair Value
   
Gross
Unrealized
Loss
   
Number of
Securities
   
Estimated
Fair Value
   
Gross
Unrealized
Loss
   
Number of
Securities
 
                                                       
Securities available for sale
                                                     
Fixed maturities
                                                     
U.S. Treasury securities and obligations of U.S. governmental instrumentalities
 
$
12,940
   
$
(14
)
   
1
   
$
-
   
$
-
     
-
   
$
12,940
   
$
(14
)
   
1
 
Obligations of the Commonwealth of Puerto Rico and its instrumentalities
   
12,704
     
(37
)
   
6
     
-
     
-
     
-
     
12,704
     
(37
)
   
6
 
Municipal securities
   
64,518
     
(304
)
   
9
     
-
     
-
     
-
     
64,518
     
(304
)
   
9
 
Corporate bonds
   
84,093
     
(367
)
   
18
     
-
     
-
     
-
     
84,093
     
(367
)
   
18
 
Collateralized mortgage obligations
   
26,043
     
(222
)
   
6
     
665
     
(2
)
   
1
     
26,708
     
(224
)
   
7
 
Total fixed maturities
   
200,298
     
(944
)
   
40
     
665
     
(2
)
   
1
     
200,963
     
(946
)
   
41
 
Equity securities-Mutual funds
   
2,831
     
(49
)
   
4
     
2,006
     
(68
)
   
1
     
4,837
     
(117
)
   
5
 
Total for securities available for sale
 
$
203,129
   
$
(993
)
   
44
   
$
2,671
   
$
(70
)
   
2
   
$
205,800
   
$
(1,063
)
   
46
 
 
Triple-S Management Corporation
Notes to Condensed Consolidated Financial Statements
(dollar amounts in thousands, except per share data)
(unaudited)
 
   
December 31, 2016
 
   
Less than 12 months
   
12 months or longer
   
Total
 
   
Estimated
Fair Value
   
Gross
Unrealized
Loss
   
Number of
Securities
   
Estimated
Fair Value
   
Gross
Unrealized
Loss
   
Number of
Securities
   
Estimated
Fair Value
   
Gross
Unrealized
Loss
   
Number of
Securities
 
                                                       
Securites available for sale
                                                     
Fixed maturities
                                                     
Obligations of government-sponsored enterprises
 
$
9,483
   
$
(15
)
   
1
   
$
-
   
$
-
     
-
   
$
9,483
   
$
(15
)
   
1
 
U.S. Treasury securities and obligations of U.S. governmental instrumentalities
   
12,937
     
(9
)
   
1
     
-
     
-
     
-
     
12,937
     
(9
)
   
1
 
Obligations of the Commonwealth of Puerto Rico and its instrumentalities
   
7,758
     
(68
)
   
5
     
-
     
-
     
-
     
7,758
     
(68
)
   
5
 
Municipal securities
   
84,252
     
(559
)
   
13
     
-
     
-
     
-
     
84,252
     
(559
)
   
13
 
Corporate bonds
   
105,054
     
(661
)
   
22
     
-
     
-
     
-
     
105,054
     
(661
)
   
22
 
Collateralized mortgage obligations
   
32,120
     
(239
)
   
8
     
784
     
(3
)
   
1
     
32,904
     
(242
)
   
9
 
Total fixed maturities
   
251,604
     
(1,551
)
   
50
     
784
     
(3
)
   
1
     
252,388
     
(1,554
)
   
51
 
Equity securities-Mutual funds
   
22,615
     
(451
)
   
4
     
-
     
-
     
-
     
22,615
     
(451
)
   
4
 
Total for securities available for sale
 
$
274,219
   
$
(2,002
)
   
54
   
$
784
   
$
(3
)
   
1
   
$
275,003
   
$
(2,005
)
   
55
 

The Corporation reviews the investment portfolios under the Corporation’s impairment review policy.  Given market conditions and the significant judgments involved, there is a continuing risk that declines in fair value may occur and material other-than-temporary impairments may be recorded in future periods.  The Corporation from time to time may sell investments as part of its asset/liability management process or to reposition its investment portfolio based on current and expected market conditions.
 
Obligations of U.S. Government Instrumentalities and Municipal Securities:   The unrealized losses on the Corporation’s investments in U.S. Government Instrumentalities and Municipal Securities were mainly caused by fluctuations in interest rates and general market conditions.  The contractual terms of these investments do not permit the issuer to settle the securities at a price less than the par value of the investment.  In addition, these investments have investment grade ratings. Because the decline in fair value is attributable to changes in interest rates and not credit quality; because the Corporation does not intend to sell the investments and it is not more likely than not that the Corporation will be required to sell the investments before recovery of their amortized cost basis, which may be maturity; and because the Corporation expects to collect all contractual cash flows, these investments are not considered other-than-temporarily impaired.
 
Obligations of the Commonwealth of Puerto Rico and its Instrumentalities : Our holdings in Puerto Rico municipals can be divided in (1) escrowed bonds with a fair value of $7,848 and a gross unrealized loss of $37, and (2) senior lien bonds issued by the Puerto Rico Sales Tax Financing Corporation (Cofina) with a fair value of $11,220 and a gross unrealized gain of $857.  As of March 31, 2017, investments in escrow bonds are not considered other-than-temporarily impaired based on the length of time the funds have been in a loss position, the decline in estimated fair value is principally attributable to changes in interest rates, and the fact that these bonds are backed by US Government securities, and therefore have an implicit AA+/Aaa rating. 
 
There was no impairment on Cofina during the three months ended March 31, 2017 and 2016.
 
Corporate Bonds :   The unrealized losses of these bonds were principally caused by fluctuations in interest rates and general market conditions.  All corporate bonds with an unrealized loss have investment grade ratings.  Because the decline in estimated fair value is principally attributable to changes in interest rates; because the Company does not intend to sell the investments and it is not more likely than not that the Company will be required to sell the investments before recovery of their amortized cost basis, which may be maturity; and because the Company expects to collect all contractual cash flows, these investments are not considered other-than-temporarily impaired.
 
Triple-S Management Corporation
Notes to Condensed Consolidated Financial Statements
(dollar amounts in thousands, except per share data)
(unaudited)
 
Collateralized mortgage obligations : The unrealized losses on investments collateralized mortgage obligations (“CMOs”) were mostly caused by fluctuations in interest rates and credit spreads. The contractual cash flows of these securities, other than private CMOs, are guaranteed by a U.S. government-sponsored enterprise. Any loss in these securities is determined according to the seniority level of each tranche, with the least senior (or most junior), typically the unrated residual tranche, taking any initial loss. The investment grade credit rating of our securities reflects the seniority of the securities that the Corporation owns. The Corporation does not consider these investments other-than-temporarily impaired because the decline in fair value is attributable to changes in interest rates and not credit quality; the Corporation does not intend to sell the investments and it is more likely than not that the Corporation will not be required to sell the investments before recovery of their amortized cost basis, which may be maturity; and because the Corporation expects to collect all contractual cash flows.
 
Mutual Funds:   As of March 31, 2017, investments in mutual funds with unrealized losses are not considered other-than-temporarily impaired based on market conditions and the length of time the funds have been in a loss position.  There were no impairment on mutual funds during the three months ended March 31, 2017 and 2016.
 
Maturities of investment securities classified as available for sale and held to maturity were as follows:
 
   
March 31, 2017
 
   
Amortized
cost
   
Estimated
fair value
 
Securities available for sale:
           
Due in one year or less
 
$
48,742
   
$
48,946
 
Due after one year through five years
   
322,122
     
325,519
 
Due after five years through ten years
   
131,128
     
137,138
 
Due after ten years
   
561,095
     
598,497
 
Residential mortgage-backed securities
   
638
     
667
 
Collateralized mortgage obligations
   
42,919
     
42,778
 
   
$
1,106,644
   
$
1,153,545
 
Securities held to maturity:
               
Due in one year or less
 
$
1,704
   
$
1,704
 
Due after ten years
   
619
     
779
 
Residential mortgage-backed securities
   
191
     
209
 
   
$
2,514
   
$
2,692
 

Expected maturities may differ from contractual maturities because some issuers have the right to call or prepay obligations with or without call or prepayment penalties.
 
Triple-S Management Corporation
Notes to Condensed Consolidated Financial Statements
(dollar amounts in thousands, except per share data)
(unaudited)
 
Information regarding realized and unrealized gains and losses from investments is as follows:

   
Three months ended
March 31,
 
   
2017
   
2016
 
Realized gains (losses):
           
Fixed maturity securities:
           
Securities available for sale:
           
Gross gains from sales
 
$
17
   
$
961
 
Gross losses from sales
   
(119
)
   
(1,359
)
Total fixed maturity securities
   
(102
)
   
(398
)
Equity securities:
               
Securities available for sale:
               
Gross gains from sales
   
438
     
587
 
Gross losses from sales
   
-
     
(131
)
Total equity securities
   
438
     
456
 
Net realized gains on securities available for sale
 
$
336
   
$
58
 
 
   
Three months ended
March 31,
 
   
2017
   
2016
 
Changes in net unrealized gains (losses):
           
Recognized in accumulated other comprehensive income:
           
Fixed maturities – available for sale
 
$
(439
)
 
$
22,589
 
Equity securities – available for sale
   
11,143
     
6,769
 
   
$
10,704
   
$
29,358
 
Not recognized in the consolidated financial statements:
               
Fixed maturities – held to maturity
 
$
2
   
$
36
 

The change in deferred tax liability on unrealized gains recognized in accumulated other comprehensive income during the three months ended March 31, 2017 and 2016 was $2,136 and $ 9,781 , respectively.
 
As of March 31, 2017 and December 31, 2016, no individual investment in securities exceeded 10% of stockholders’ equity.
 
Triple-S Management Corporation
Notes to Condensed Consolidated Financial Statements
(dollar amounts in thousands, except per share data)
(unaudited)
 
(4)
Premiums and Other Receivables, Net
 
Premiums and other receivables, net were as follows:

   
March 31,
2017
   
December 31,
2016
 
Premium
 
$
100,691
   
$
91,528
 
Self-funded group receivables
   
50,643
     
57,728
 
FEHBP
   
14,274
     
14,321
 
Agent balances
   
27,468
     
25,495
 
Accrued interest
   
11,338
     
13,668
 
Reinsurance recoverable
   
54,854
     
58,295
 
Other
   
65,152
     
62,637
 
     
324,420
     
323,672
 
Less allowance for doubtful receivables:
               
Premium
   
23,584
     
27,320
 
Other
   
7,999
     
9,987
 
     
31,583
     
37,307
 
Total premium and other receivables, net
 
$
292,837
   
$
286,365
 

As of March 31, 2017 and December 31, 2016, the Company had premiums and other receivables of $51,533 and $57,750, respectively, from the Government of Puerto Rico, including its agencies, municipalities and public corporations.  The related allowance for doubtful receivables as of March 31, 2017 and December 31, 2016 were $14,050 and $18,812, respectively.
 
Triple-S Management Corporation
Notes to Condensed Consolidated Financial Statements
(dollar amounts in thousands, except per share data)
(unaudited)

(5)
Fair Value Measurements
 
Our condensed consolidated balance sheets include the following financial instruments: securities available for sale, policy loans, policyholder deposits, and long-term borrowings.  We consider the carrying amounts of policy loans, policyholder deposits, and long-term borrowings to approximate their fair value due to the short period of time between the origination of these instruments and the expected realization or payment. Certain assets are measured at fair value on a recurring basis and are disclosed below. These assets are classified into one of three levels of a hierarchy defined by GAAP. For a description of the methods and assumptions that are used to estimate the fair value and determine the fair value hierarchy classification of each class of financial instrument, see the consolidated financial statements and notes thereto included in our 2016 Form 10-K.
 
The following tables summarize fair value measurements by level for assets measured at fair value on a recurring basis:
 
   
March 31, 2017
 
   
Level 1
   
Level 2
   
Level 3
   
Total
 
Securities available for sale:
                       
Fixed maturity securities
                       
Obligations of government-sponsored enterprises
  $ -    
$
41,546
   
$
-
    $ 41,546  
U.S. Treasury securities and obligations of U.S government instrumentalities
72,878
-
     
-
     
72,878
 
Obligations of the Commonwealth of Puerto Rico and its instrumentalities
-
19,068
     
-
     
19,068
 
Municipal securities
   
-
     
684,978
     
-
     
684,978
 
Corporate bonds
   
-
     
291,630
     
-
     
291,630
 
Residential agency mortgage-backed securities
   
-
     
667
     
-
     
667
 
Collateralized mortgage obligations
   
-
     
42,778
     
-
     
42,778
 
Total fixed maturities
   
72,878
     
1,080,667
     
-
     
1,153,545
 
Equity securities - Mutual funds
   
174,593
     
78,803
     
23,753
     
277,149
 
Total
 
$
247,471
   
$
1,159,470
   
$
23,753
   
$
1,430,694
 
 
   
December 31, 2016
 
   
Level 1
   
Level 2
   
Level 3
   
Total
 
Securities available for sale:
                       
Fixed maturity securities
                       
Obligations of government-sponsored enterprises
 
$
-
   
$
41,514
   
$
-
   
$
41,514
 
U.S. Treasury securities and obligations of U.S government instrumentalities
   
85,800
     
-
     
-
     
85,800
 
Obligations of the Commonwealth of Puerto Rico and its instrumentalities
   
-
     
20,051
     
-
     
20,051
 
Municipal securities
   
-
     
683,803
     
-
     
683,803
 
Corporate bonds
   
-
     
274,872
     
-
     
274,872
 
Residential agency mortgage-backed securities
   
-
     
718
     
-
     
718
 
Collateralized mortgage obligations
   
-
     
44,885
     
-
     
44,885
 
Total fixed maturities
   
85,800
     
1,065,843
     
-
     
1,151,643
 
Equity securities - Mutual funds
   
166,595
     
76,222
     
27,532
     
270,349
 
Total
 
$
252,395
   
$
1,142,065
   
$
27,532
   
$
1,421,992
 

There were no transfers in and/or out of Level 3 and between Levels 1 and 2 during the three months ended March 31, 2017 and 2016.
 
Triple-S Management Corporation
Notes to Condensed Consolidated Financial Statements
(dollar amounts in thousands, except per share data)
(unaudited)
 
A reconciliation of the beginning and ending balances of assets measured at fair value on a recurring basis using significant unobservable inputs (Level 3) for the three months ended March 31 is as follows:

   
Fair Value Measurements
Using Significant
Unobservable Inputs (Level 3)
 
   
2017
   
2016
 
Beginning balance
 
$
27,532
   
$
7,958
 
Realized gains
   
119
     
151
 
Unrealized in other accumulated comprehensive income
   
(64
)
   
(649
)
Purchases
   
5,260
     
8
 
Capital distributions
   
(9,094
)
   
(471
)
Ending balance
 
$
23,753
   
$
6,997
 

A summary of the carrying value and fair value by level of financial instruments not recorded at fair value on our condensed consolidated balance sheets at March 31, 2017 and December 31, 2016 are as follows:
 
   
March 31, 2017
 
    
Carrying
Value
    
Fair Value
 
Level 1
   
Level 2
   
Level 3
   
Total
 
Assets:
                             
Policy loans
 
$
8,546
   
$
-
   
$
8,546
   
$
-
   
$
8,546
 
                                         
Liabilities:
                                       
Policyholder deposits
 
$
179,599
   
$
-
   
$
179,599
   
$
-
   
$
179,599
 
Long-term borrowings:
                                       
Loans payable to bank - variable
   
34,465
     
-
     
34,465
     
-
     
34,465
 
Total long-term borrowings
   
34,465
     
-
     
34,465
     
-
     
34,465
 
Total liabilities
 
$
214,064
   
$
-
   
$
214,064
   
$
-
   
$
214,064
 
 
   
December 31, 2016
 
    
Carrying
Value
    
Fair Value
 
Level 1
   
Level 2
   
Level 3
   
Total
 
Assets:
                             
Policy loans
 
$
8,564
   
$
-
   
$
8,564
   
$
-
   
$
8,564
 
                                         
Liabilities:
                                       
Policyholder deposits
 
$
179,382
   
$
-
   
$
179,382
   
$
-
   
$
179,382
 
Long-term borrowings:
                                       
Loans payable to bank - variable
   
11,187
     
-
     
11,187
     
-
     
11,187
 
6.6% senior unsecured notes payable
   
24,000
     
-
     
24,000
     
-
     
24,000
 
Total long-term borrowings
   
35,187
     
-
     
35,187
     
-
     
35,187
 
Total liabilities
 
$
214,569
   
$
-
   
$
214,569
   
$
-
   
$
214,569
 
 
Triple-S Management Corporation
Notes to Condensed Consolidated Financial Statements
(dollar amounts in thousands, except per share data)
(unaudited)
 
(6)
Claim Liabilities
 
A reconciliation of the beginning and ending balances of claim liabilities is as follows:

   
Three months ended
March 31, 2017
 
   
Managed
Care
   
Other
Business
Segments *
   
Consolidated
 
                   
Claim liabilities at beginning of year
 
$
349,047
   
$
138,896
   
$
487,943
 
Reinsurance recoverable on claim liabilities
   
-
     
(38,998
)
   
(38,998
)
Net claim liabilities at beginning of year
   
349,047
     
99,898
     
448,945
 
Claims incurred
                       
Current period insured events
   
602,620
     
28,226
     
630,846
 
Prior period insured events
   
(15,340
)
   
(1,333
)
   
(16,673
)
Total
   
587,280
     
26,893
     
614,173
 
Payments of losses and loss-adjustment expenses
                       
Current period insured events
   
350,450
     
7,965
     
358,415
 
Prior period insured events
   
192,352
     
17,945
     
210,297
 
Total
   
542,802
     
25,910
     
568,712
 
Net claim liabilities at end of year
   
393,525
     
100,881
     
494,406
 
Reinsurance recoverable on claim liabilities
   
-
     
35,898
     
35,898
 
Claim liabilities at end of year
 
$
393,525
   
$
136,779
   
$
530,304
 
 
Triple-S Management Corporation
Notes to Condensed Consolidated Financial Statements
(dollar amounts in thousands, except per share data)
(unaudited)
 
   
Three months ended
March 31, 2016
 
   
Managed
Care
   
Other
Business
Segments *
   
Consolidated
 
                   
Claim liabilities at beginning of year
 
$
348,297
   
$
143,468
   
$
491,765
 
Reinsurance recoverable on claim liabilities
   
-
     
(40,714
)
   
(40,714
)
Net claim liabilities at beginning of year
   
348,297
     
102,754
     
451,051
 
Claims incurred
                       
Current period insured events
   
614,754
     
25,890
     
640,644
 
Prior period insured events
   
(18,464
)
   
(2,248
)
   
(20,712
)
Total
   
596,290
     
23,642
     
619,932
 
Payments of losses and loss-adjustment expenses
                       
Current period insured events
   
365,039
     
5,096
     
370,135
 
Prior period insured events
   
198,100
     
17,553
     
215,653
 
Total
   
563,139
     
22,649
     
585,788
 
Net claim liabilities at end of year
   
381,448
     
103,747
     
485,195
 
Reinsurance recoverable on claim liabilities
   
-
     
39,871
     
39,871
 
Claim liabilities at end of year
 
$
381,448
   
$
143,618
   
$
525,066
 

*
Other Business Segments include the Life Insurance and Property and Casualty segments, as well as intersegment eliminations.

As a result of differences between actual amounts and estimates of insured events in prior years, the amounts included as incurred claims for prior period insured events differ from anticipated claims incurred.
 
The favorable developments in the claims incurred and loss-adjustment expenses for prior period insured events for the three months ended March 31, 2017 and 2016 are due primarily to better than expected utilization trends.  Reinsurance recoverable on unpaid claims is reported as premium and other receivables, net in the accompanying consolidated financial statements.
 
The claims incurred disclosed in this table exclude the portion of the change in the liability for future policy benefits expense, which amounted to $6,690 and $6,762 during the three months ended March 31, 2017 and 2016, respectively.
 
Triple-S Management Corporation
Notes to Condensed Consolidated Financial Statements
(dollar amounts in thousands, except per share data)
(unaudited)
 
The following is information about total incurred but not reported (IBNR) liabilities plus expected development on reported claims included in the liability for unpaid claims adjustment expenses for the Managed Care segment as of March 31, 2017.
 
Incurred
Year
 
Total of IBNR Liabilities Plus Expected
Development on Reported Claims
   
2015
   
60,717
   
2016
   
80,062
   
2017
   
252,163
   

(7)
Long-Term Borrowings
 
A summary of the borrowings entered by the Company is as follows:
 
   
March 31,
2017
   
December 31,
2016
 
             
Senior unsecured notes payable of $60,000 issued on December 2005; due December 2020. Interest is payable monthly at a fixed rate of 6.60%.
 
$
-
   
$
24,000
 
Secured loan payable of $11,187, payable in monthly installments of $137 through October 1, 2023, plus interest at a rate reset periodically of 100 basis points over selected LIBOR maturity (which was 1.79% at March 31, 2017.)
   
10,777
     
11,187
 
Secured loan payable of $20,150, payable in monthly installments of $84 through January 1, 2024, plus interest at a rate reset periodically of 275 basis points over selected LIBOR maturity (which was 3.77% at March 31, 2017.)
   
19,982
     
-
 
Secured loan payable of $4,116, payable in monthly installments of $49 through January 1, 2024, plus interest at a rate reset periodically of 325 basis points over selected LIBOR maturity (which was 4.27% at March 31, 2017.)
   
4,018
     
-
 
Total borrowings
   
34,777
     
35,187
 
                 
Less unamortized debt issuance costs
   
312
     
102
 
   
$
34,465
   
$
35,085
 

On December 28, 2016, TSM entered into a $35,500 credit agreement with a commercial bank in Puerto Rico. The agreement consists of three term loans: (i) Term Loan A in the principal amount of $11,187, (ii) Term Loan B in the principal amount of $20,150 and (iii) Term Loan C in the principal amount of $4,116.  Term Loan A was used to refinance the previous $41,000 secured loan payable with the same commercial bank in Puerto Rico.  Proceeds from Term Loans B and C were received on January 11, 2017 and were used to prepay the outstanding principal amount plus accrued interest of the 6.6% Senior Unsecured Notes due January 2021 ($24,000), and fund a portion of a debt service reserve for the Loan (approximately $200).  Interest payable commenced on January 1, 2017, in the case of Term Loan A, and on February 1, 2017, in the case of Term Loan B and Term Loan C.  The Credit Agreement includes certain financial and non-financial covenants, including negative covenants imposing certain restrictions on the Corporation’s business.
 
Triple-S Management Corporation
Notes to Condensed Consolidated Financial Statements
(dollar amounts in thousands, except per share data)
(unaudited)
 
On March 11, 2016 Triple-S Salud, Inc. (TSS) entered into a $30,000 revolving loan agreement with a commercial bank in Puerto Rico. This unused line of credit had an interest rate of LIBOR plus 220 basis points and contained certain financial and non-financial covenants that are customary for this type of facility. This revolving loan agreement matured on March 11, 2017, and was not renewed.
 
On April 18, 2017, Triple-S Advantage, Inc. (TSA) entered into a $10,000 revolving loan agreement with a commercial bank in Puerto Rico. This unused line of credit has an interest rate of 30-day LIBOR plus 25 basis points, matures on April 17, 2018, and includes certain financial and non-financial covenants that are customary for this type of facility.
 
(8)
Pension Plan
 
The components of net periodic benefit cost for the three months ended March 31 were as follows:
 
   
Three months ended
March 31,
 
   
2017
   
2016
 
Components of net periodic benefit cost:
           
Service cost
 
$
-
   
$
1,250
 
Interest cost
   
1,798
     
2,762
 
Expected return on assets
   
(2,199
)
   
(2,926
)
Amortization of prior service benefit
   
-
     
(144
)
Amortization of actuarial loss
   
86
     
1,183
 
Net periodic benefit cost
 
$
(315
)
 
$
2,125
 

Effective January 31, 2017, the Company froze the pay and service amounts used to calculate pension benefits for active employees who participated in the pension plan. Therefore, as of the Effective Date, active employees in the pension plan will not accrue additional benefits for future service and eligible compensation received.
 
Employer Contributions:   The Corporation disclosed in its audited consolidated financial statements for the year ended December 31, 2016 that it expected to contribute $4,000 to the pension program in 2017.  As of March 31, 2017, the Corporation has not made contributions to the pension program.
 
Triple-S Management Corporation
Notes to Condensed Consolidated Financial Statements
(dollar amounts in thousands, except per share data)
(unaudited)
 
(9)
Comprehensive Income
 
The accumulated balances for each classification of other comprehensive income, net of tax, are as follows:
 
   
Three months ended
March 31,
 
   
2017
   
2016
 
             
Net Unrealized Gain on Securities Beginning Balance
 
$
62,371
   
$
62,478
 
Other comprehensive income before reclassifications
   
8,741
     
19,623
 
Amounts reclassified from accumulated other comprehensive income
   
(269
)
   
(46
)
Net current period change
   
8,472
     
19,577
 
Ending Balance
   
70,843
     
82,055
 
Liability for Pension Benefits Beginning Balance
   
(19,976
)
   
(36,855
)
Amounts reclassified from accumulated other comprehensive income
   
53
     
634
 
Ending Balance
   
(19,923
)
   
(36,221
)
Accumulated Other Comprehensive Income Beginning Balance
   
42,395
     
25,623
 
Other comprehensive income before reclassifications
   
8,741
     
19,623
 
Amounts reclassified from accumulated other comprehensive income
   
(216
)
   
588
 
Net current period change
   
8,525
     
20,211
 
Ending Balance
 
$
50,920
   
$
45,834
 


Triple-S Management Corporation
Notes to Condensed Consolidated Financial Statements
(dollar amounts in thousands, except per share data)
(unaudited)
 
(10)
Share-Based Compensation
 
Share-based compensation (benefit) expense recorded during the three months ended March 31, 2017 and 2016 was ($1,443) and $1,085, respectively.  The benefit recorded in the 2017 period results from a decrease in the 2014 and 2015 grants expected performance shares payouts.  There were no stock option exercises during the three months ended March 31, 2017 and 2016.
 
(11)
Net Income Available to Stockholders and Net Income per Share
 
The following table sets forth the computation of basic and diluted earnings per share:

   
Three months ended
March 31,
 
   
2017
   
2016
 
Numerator for earnings per share:
           
Net (loss) income attributable to TSM available to stockholders
 
$
(4,342
)
 
$
3,456
 
Denominator for basic earnings per share:
               
Weighted average of common shares
   
24,143,261
     
24,587,681
 
Effect of dilutive securities
   
-
     
72,353
 
Denominator for diluted earnings per share
   
24,143,261
     
24,660,034
 
Basic net (loss) income per share attributable to TSM
 
$
(0.18
)
 
$
0.14
 
Diluted net (loss) income per share attributable to TSM
 
$
(0.18
)
 
$
0.14
 

The Company generated a loss from continuing operations attributable to the Company’s common stockholders for the three months ended March 31, 2017, so the effect of dilutive securities is not considered because their effect would be antidilutive. If the Company had generated income from continuing operations during the three months ended March 31, 2017, the effect of restricted stock awards on the diluted shares calculation would have been an increase in shares of 59,284 shares.
 
(12)
Contingencies
 
The following information supplements and amends, as applicable, the disclosures in Note 24 to the Consolidated Financial Statements of the Company’s 2016 Annual Report on Form 10-K.  Our business is subject to numerous laws and regulations promulgated by Federal, Puerto Rico, USVI, Costa Rica, BVI, and Anguilla governmental authorities. Compliance with these laws and regulations can be subject to government review and interpretation, as well as regulatory actions unknown and unasserted at this time. The Commissioner of Insurance of Puerto Rico, as well as other Federal, Puerto Rico, USVI, Costa Rica, BVI, and Anguilla government authorities, regularly make inquiries and conduct audits concerning the Company’s compliance with such laws and regulations. Penalties associated with violations of these laws and regulations may include significant fines and exclusion from participating in certain publicly funded programs and may require the Company to comply with corrective action plans or changes in our practices.
 
We are involved in various legal actions arising in the ordinary course of business. We are also defendants in various other litigations and proceedings, some of which are described below.  Where the Company believes that a loss is both probable and estimable, such amounts have been recorded.  Although we believe our estimates of such losses are reasonable, these estimates could change as a result of further developments in these matters. In other cases, it is at least reasonably possible that the Company may incur a loss related to one or more of the mentioned pending lawsuits or investigations, but the Company is unable to estimate the range of possible loss which may be ultimately realized, either individually or in the aggregate, upon their resolution.  The outcome of legal proceedings is inherently uncertain and pending matters for which accruals have not been established have not progressed sufficiently to enable us to estimate a range of possible loss, if any.  Given the inherent unpredictability of these matters, it is possible that an adverse outcome in one or more of these matters could have a material adverse effect on the consolidated financial condition, operating results and/or cash flows of the Company.
 
Triple-S Management Corporation
Notes to Condensed Consolidated Financial Statements
(dollar amounts in thousands, except per share data)
(unaudited)
 
Additionally, we may face various potential litigation claims that have not been asserted to date, including claims from persons purporting to have rights to acquire shares of the Company on favorable terms pursuant to agreements previously entered by our predecessor managed care subsidiary, Seguros de Servicios de Salud de Puerto Rico, Inc. (SSS), with physicians or dentists who joined our provider network to sell such new provider shares of SSS at a future date (Share Acquisition Agreements) or to have inherited such shares notwithstanding applicable transfer and ownership restrictions.
 
ASES Audits
 
The Company is subject to numerous audits in connection with the provision of services to private and governmental entities.  These audits may include numerous aspects of our business, including claim payment practices, contractual obligations, service delivery, third-party obligations, and business practices, among others.  Deficiencies in audits could have a material adverse effect on our reputation and business, including termination of contracts, significant increases in the cost of managing and remediating deficiencies, payment of contractual penal clauses, and others, any of which could have a material and adverse effect on our results of operations, financial position and cash flows.
 
On July 2, 2014, ASES notified TSS that the results of an audit conducted in connection with the government health plan contract for several periods between October 2005 to September 2013, reflected an overpayment of premiums made to TSS pursuant to prior contracts with ASES in the amount of $7,900. The alleged overpayments were related to duplicated payments or payments made for deceased members, and ASES requested the reimbursement of the alleged overpayment. On January 16, 2015, TSS filed an injunction against ASES under the case Triple-S Salud, Inc. v. Administracion de Seguros de Salud de Puerto Rico. TSS contends that ASES’ request for reimbursement has no merits on several grounds, including a 2011 settlement between both parties covering the majority of the amount claimed by ASES, and that ASES, under the terms of the contracts, was responsible for certifying the membership. TSS also amended its claim to include the Puerto Rico Health Department (PRHD), as it asserts the PRHD is an indispensable party for the resolution of this matter and to seek the payment of approximately $5,000, since the premiums paid to TSS should have been higher than what ASES actually paid given the additional risk assumed by TSS. The case was assigned to a Special Commissioner, who has received a joint expert report concerning the case. On March 17, 2017, the Special Commissioner issued a report recommending the court to dismiss the complaint in favor of TSS. TSS is awaiting the court’s decision in connection to the report issued by the Special Commissioner. TSS will continue to conduct a vigorous defense of this matter.
 
Triple-S Management Corporation
Notes to Condensed Consolidated Financial Statements
(dollar amounts in thousands, except per share data)
(unaudited)
 
(13)
Segment Information
 
The operations of the Corporation are conducted principally through three business segments: Managed Care, Life Insurance, and Property and Casualty Insurance.  The Corporation evaluates performance based primarily on the operating revenues and operating income of each segment.  Operating revenues include premiums earned, net, administrative service fees, net investment income, and revenues derived from other segments.  Operating costs include claims incurred and operating expenses.  The Corporation calculates operating income or loss as operating revenues less operating costs.
 
The following tables summarize the operations by reportable segment for the three months ended March 31, 2017 and 2016:

   
Three months ended
March 31,
 
   
2017
   
2016
 
Operating revenues:
           
Managed Care:
           
Premiums earned, net
 
$
640,147
   
$
678,380
 
Administrative service fees
   
4,379
     
5,083
 
Intersegment premiums/service fees
   
1,534
     
1,485
 
Net investment income
   
3,892
     
3,480
 
Total managed care
   
649,952
     
688,428
 
Life Insurance:
               
Premiums earned, net
   
40,298
     
38,966
 
Intersegment premiums
   
191
     
137
 
Net investment income
   
6,087
     
5,914
 
Total life insurance
   
46,576
     
45,017
 
Property and Casualty Insurance:
               
Premiums earned, net
   
21,548
     
21,188
 
Intersegment premiums
   
153
     
153
 
Net investment income
   
1,924
     
1,929
 
Total property and casualty insurance
   
23,625
     
23,270
 
Other segments: *
               
Intersegment service revenues
   
1,586
     
2,545
 
Operating revenues from external sources
   
1,000
     
856
 
Total other segments
   
2,586
     
3,401
 
Total business segments
   
722,739
     
760,116
 
TSM operating revenues from external sources
   
78
     
4
 
Elimination of intersegment premiums/service fees
   
(1,598
)
   
(1,775
)
Elimination of intersegment service revenues
   
(1,586
)
   
(2,545
)
Other intersegment eliminations
   
-
     
(13
)
Consolidated operating revenues
 
$
719,633
   
$
755,787
 

*
Includes segments that are not required to be reported separately, primarily the data processing services organization and the health clinic.
 
Triple-S Management Corporation
Notes to Condensed Consolidated Financial Statements
(dollar amounts in thousands, except per share data)
(unaudited)
 
   
Three months ended
March 31,
 
   
2017
   
2016
 
Operating income (loss):
           
Managed care
 
$
(18,582
)
 
$
(641
)
Life insurance
   
3,935
     
5,598
 
Property and casualty insurance
   
2,067
     
2,111
 
Other segments *
   
143
     
(179
)
Total business segments
   
(12,437
)
   
6,889
 
TSM operating revenues from external sources
   
78
     
4
 
TSM unallocated operating expenses
   
(2,217
)
   
(3,167
)
Elimination of TSM intersegment charges
   
2,400
     
2,387
 
Consolidated operating (loss) income
   
(12,176
)
   
6,113
 
Consolidated net realized investment gains
   
336
     
58
 
Consolidated interest expense
   
(1,686
)
   
(1,882
)
Consolidated other income, net
   
2,525
     
875
 
Consolidated (loss) income before taxes
 
$
(11,001
)
 
$
5,164
 
                 
Depreciation and amortization expense:
               
Managed care
 
$
2,239
   
$
2,934
 
Life insurance
   
280
     
255
 
Property and casualty insurance
   
114
     
161
 
Other segments*
   
160
     
153
 
Total business segments
   
2,793
     
3,503
 
TSM depreciation expense
   
197
     
197
 
Consolidated depreciation and amortization expense
 
$
2,990
   
$
3,700
 

*
Includes segments that are not required to be reported separately, primarily the data processing services organization and the health clinic.
 
Triple-S Management Corporation
Notes to Condensed Consolidated Financial Statements
(dollar amounts in thousands, except per share data)
(unaudited)
 
   
March 31,
2017
   
December 31,
2016
 
Assets:
           
Managed care
 
$
1,144,927
   
$
1,013,872
 
Life insurance
   
820,481
     
816,920
 
Property and casualty insurance
   
347,282
     
349,159
 
Other segments *
   
26,274
     
26,034
 
Total business segments
   
2,338,964
     
2,205,985
 
Unallocated amounts related to TSM:
               
Cash, cash equivalents, and investments
   
22,531
     
17,033
 
Property and equipment, net
   
22,228
     
22,380
 
Other assets
   
21,337
     
21,646
 
     
66,096
     
61,059
 
Elimination entries-intersegment receivables and others
   
(46,605
)
   
(48,045
)
Consolidated total assets
 
$
2,358,455
   
$
2,218,999
 

*
Includes segments that are not required to be reported separately, primarily the data processing services organization and the health clinic.
 
Triple-S Management Corporation
Notes to Condensed Consolidated Financial Statements
(dollar amounts in thousands, except per share data)
(unaudited)
 
(14)
Subsequent Events
 
The Company evaluated subsequent events through the date the financial statements were issued.  No events, other than those described in these notes, have occurred that require adjustment or disclosure pursuant to current Accounting Standards Codification.
 
Item 2.
Management’s Discussion and Analysis of Financial Condition and Results of Operations
 
In this Management’s Discussion and Analysis of Financial Condition and Results of Operations (MD&A), the “Corporation”, the “Company”, “TSM”, “we”, “us” and “our” refers to Triple-S Management Corporation and its subsidiaries.  The MD&A 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 for the three months ended March 31, 2017.  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, 2016 and the MD&A included therein, and our unaudited consolidated financial statements and accompanying notes as of and for the three months ended March 31, 2017 included in this Quarterly Report on Form 10-Q.
 
Cautionary Statement Regarding Forward-Looking Information
 
This Quarterly Report on Form 10-Q and other of our publicly available documents 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 our business and our financial condition and results of operations.  These statements are not historical, but instead represent our belief regarding future events, any of which, by their nature, are inherently uncertain and outside of our control.  These statements may address, among other things, future financial results, strategy for growth, and market position.  It is possible that our 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.  We are 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.
 
Overview
 
We are one of the most significant players in the managed care industry in Puerto Rico and have over 55 years of experience in this industry.  We offer a broad portfolio of managed care and related products in the Commercial, Medicaid and Medicare Advantage markets.  In the Commercial market we offer products to corporate accounts, U.S. federal government employees, local government employees, individual accounts and Medicare Supplement.  We also participate in the Government of Puerto Rico Health Insurance Plan (a government of Puerto Rico-funded managed care program for the medically indigent that is similar to the Medicaid program in the U.S.) (Medicaid), by administering the provision of health benefits in designated service regions in Puerto Rico.  See details of the Medicaid contract in Item 1A of Part I of our Annual Report on Form 10-K for the year ended December 31, 2016 under the sub-caption “ We are dependent on a small number of government contracts to generate a significant amount of the revenues of our managed care business.
 
We have the exclusive right to use the Blue Cross Blue Shield (BCBS) name and mark throughout Puerto Rico, the U.S. Virgin Islands, Costa Rica, the British Virgin Islands and Anguilla.  As of March 31, 2017, we served approximately 1,016,000 members across all regions of Puerto Rico.  For the three months ended March 31, 2017 and 2016 respectively, our managed care segment represented approximately 91% and 92% of our total consolidated premiums earned.  We also have significant positions in the life insurance and property and casualty insurance markets.
 
We participate in the managed care market through our subsidiaries, Triple-S Salud, Inc. (TSS) and Triple-S Advantage, Inc. (TSA), and Triple-S Blue, Inc . I.I. (TSB).  TSS, TSA and TSB are Blue Cross Blue Shield Association (BCBSA) licensees, which provides us with exclusive use of the Blue Cross and Blue Shield name and mark throughout Puerto Rico, the U.S. Virgin Islands, Costa Rica, the British Virgin Islands, and Anguilla.
 
We participate in the life insurance market through our subsidiary, Triple-S Vida, Inc., and in the property and casualty insurance market through our subsidiary, Triple-S Propiedad, Inc. (TSP).
 
Intersegment revenues and expenses are reported on a gross basis in each of the operating segments but eliminated in the consolidated results.  Except as otherwise indicated, the numbers for each segment presented in this Quarterly Report on Form 10-Q do not reflect intersegment eliminations.  These intersegment revenues and expenses affect the amounts reported on the financial statement line items for each segment, but are eliminated in consolidation and do not change net income.  See note 13 of the Condensed Consolidated Financial Statements included in Quarterly Report on Form 10-Q.
 
Our revenues primarily consist of premiums earned, net and administrative service fees.  These revenues are derived from the sale of managed care products in the Commercial market to employer groups, individuals and government-sponsored programs, principally Medicare and the Government of Puerto Rico Health Insurance Plan.  Premiums are derived from insurance contracts and administrative service fees are derived from self-funded contracts, under which we provide a range of services, including claims administration, billing and membership services, among others.  Revenues also include premiums earned from the sale of property and casualty and life insurance contracts, and investment income and revenues derived from other segments.  Substantially all of our earnings are generated in Puerto Rico.
 
Claims incurred include the payment of benefits and losses, mostly to physicians, hospitals and other service providers, and to policyholders.  Each segment’s results of operations depend to a significant extent on their ability to accurately predict and effectively manage claims.  A portion of the claims incurred for each period consists of claims reported but not paid during the period, as well as a management and actuarial estimate of claims incurred but not reported during the period.  Operating expenses consist primarily of compensation, commission payments to brokers and other overhead business expenses.
 
We use operating income as a measure of performance of the underwriting and investment functions of our segments.  We also use the loss ratio and the operating expense ratio as measures of performance.  The loss ratio is claims incurred divided by premiums earned, net, multiplied by 100.  The operating expense ratio is operating expenses divided by premiums earned; net and administrative service fees, multiplied by 100.
 
Recent Developments
 
Puerto Rico Economy
 
During the past decade, Puerto Rico has been facing economic and fiscal challenges and its economy has been contracting.  In response to the Commonwealth of Puerto Rico (the Commonwealth) fiscal and economic crisis, on June 30, 2016, the U.S. Congress enacted the Puerto Rico Oversight, Management and Economic Stability Act (“PROMESA”), which, among other things, established a Federally-appointed oversight board (the “Oversight Board”) comprised of seven members with ample powers over the finances of the Commonwealth and its instrumentalities.  PROMESA also established a temporary stay on litigation to enforce rights or remedies related to financial liabilities of the Commonwealth, its instrumentalities and municipalities, which expired on May 1, 2017.  Finally, PROMESA established two separate mechanisms to restructure the debts of the Commonwealth, its public corporations and municipalities. The first mechanism permits modifications of financial indebtedness with the consent of a supermajority of affected financial creditors. The second mechanism, known as Title III, is a court-supervised debt-adjustment process, which is modeled after Chapter 9 of the U.S. Bankruptcy Code.
 
Pursuant to PROMESA, the Oversight Board required the Commonwealth to deliver a fiscal plan by January 15, 2017, which deadline was later extended until February 28, 2017.  In a letter dated January 18, 2017, the Oversight Board recommended to the Governor a series of measures for inclusion in the fiscal plan, including: (i) a $1.0 billion reduction in health care spending by fiscal year 2019, (ii) the elimination of budgetary subsidies to municipalities and (iii) significant reductions in payroll expenditures and pension and/or pension-related benefits.  On February 28, 2017, the Governor of Puerto Rico submitted a 10-year fiscal plan to the Oversight Board, for its review and approval.  After certain revisions, a final plan was approved by the Oversight Board on March 13, 2017, which includes spending reductions of $25.7 billion. The plan implies larger concessions from bondholders since there would be approximately $8 billion available for debt service payments over the next 10 years, compared to around $35 billion that is owed over that period.  The plan also proposes (i) certain significant changes to the Commonwealth’s healthcare delivery model in order to reduce expenses and (ii) the elimination of subsidies to the municipalities, many of which have contracts for the provision of healthcare or other insurance products with our subsidiaries.  The plan, however, does not provide details about the proposed changes or the timeline for their implementation.  Also, it is uncertain if and how the elimination of municipal subsidies will affect municipal finances and their ability to continue to meet their contractual obligations.
 
The Oversight Board also required that certain Commonwealth instrumentalities, such as Government Development Bank for Puerto Rico, the Puerto Rico Aqueduct and Sewer Authority, the Puerto Rico Electric Power Authority and the University of Puerto Rico, prepare and submit fiscal plans.  All such fiscal plans have been submitted and approved, other than the plan for the University of Puerto Rico, and include significant expenditure reductions across all types of expenses.  In the future, the Oversight Board may require other instrumentalities and municipalities to prepare and submit fiscal plans.
On May 1, 2017, the temporary stay on litigation established by PROMESA expired. After the expiration of the temporary stay, several investors holding general obligation and sales and use tax-backed bonds filed lawsuits to enforce their rights and remedies related to the financial liabilities of the Commonwealth, its instrumentalities and municipalities. On May 3, 2017, after not reaching an agreement with its creditors, the Oversight Board filed an order seeking the protection of the provisions of Title III of PROMESA for the Commonwealth.  On May 5, 2017, the Oversight Board also sought the protection of Title III of PROMESA for the Puerto Rico Sales Tax Financing Corporation (“COFINA” by its Spanish acronym), which issued the sales and use tax-backed bonds. While the proceedings under Title III of PROMESA are ongoing, all enforcement and collection actions against the Commonwealth and COFINA by its creditors are stayed.  As a result of this court-supervised debt-adjustment process, the principal and interest payments due on general obligation and sales and use tax-backed bonds will likely be restructured and such restructuring could lead to significant additional losses on such holdings.
 
Although the Oversight Board has not sought the protection of Title III of PROMESA for the Puerto Rico Health Insurance Administration (“ASES” by its Spanish acronym), the instrumentality responsible for the administration of the Government’s health plan, ASES may be affected by the Commonwealth’s fiscal plan and the proceedings commenced for the Commonwealth under Title III of PROMESA because its state-based funding is solely dependent on appropriations from the Government’s general fund. Notwithstanding the Government’s statement in recent legislation that its public policy includes guaranteeing the continuity of public services in essential areas such as health, security, education, social work and development, among others, it is uncertain how the Commonwealth’s Title III proceeding will affect ASES and the contracts administered by it.
 
If the liquidity of the Government of Puerto Rico, its agencies, municipalities and public corporations becomes significantly affected as a result of their inability to raise funding in the market or generate enough revenues, we may face credit losses in our premium and fees receivables from these and other government related entities.  As of March 31, 2017, the Company had premiums and other receivables of $51.5 million from the Government of Puerto Rico, including its agencies, municipalities and public corporations with a related allowance for doubtful receivables of $14.1 million.  We also hold several positions categorized as Obligations of the Commonwealth of Puerto Rico, including Cofina bonds, which are susceptible to aforementioned recent developments in the economy, see note 3 to the unaudited consolidated financial statements included in this Quarterly Report on Form 10-Q.
 
Puerto Rico Government Health Reform Program
 
Current Medicaid premiums rates are effective until June 30, 2017; the negotiation for new rates, until the end of the three year agreement, is ongoing.  See Item 1A.   Risk Factors—Risks Related to Our Business – “ We are dependent on a small number of government contracts to generate a significant amount of the revenues of our managed care business .’’ included in our Annual Report on Form 10-K for the year ended December 31, 2016.
 
Political and Regulatory Developments
 
CMS announced final benchmark rates for the 2018 Medicare Advantage plans.  The call letter included revenue adjustments reflecting the physician payment increases, maintaining the zero claims adjustment, and allowing certain Puerto Rico counties to qualify for double bonus status.  The impact of these updates result in a benchmark increase of about 4%. See Item 1A.   Risk Factors—Risks Related to the Regulation of our Industry – “The revised rate calculation system for Medicare Advantage, the payment system for the Medicare Part D and changes in the methodology and payment policies used by CMS to establish rates could reduce our profitability and the benefits we offer our beneficiaries’’ included in our Annual Report on Form 10-K for the year ended December 31, 2016.
 
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.
 
Managed Care Membership
 
   
As of March 31,
 
   
2017
   
2016
 
Managed care enrollment:
           
Commercial 1
   
505,848
     
544,846
 
Medicare
   
121,352
     
119,224
 
Medicaid
   
389,130
     
402,933
 
Total
   
1,016,330
     
1,067,003
 
Managed care enrollment by funding arrangement:
               
Fully-insured
   
847,327
     
886,547
 
Self-insured
   
169,003
     
180,456
 
Total
   
1,016,330
     
1,067,003
 

(1)
Commercial membership includes corporate accounts, self-funded employers, individual accounts, Medicare Supplement, Federal government employees and local government employees.
 
Consolidated Operating Results
 
The following table sets forth the Corporation’s consolidated operating results.  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,
 
(dollar amounts in millions)
 
2017
   
2016
 
Revenues:
           
Premiums earned, net
 
$
702.3
   
$
738.5
 
Administrative service fees
   
4.4
     
5.1
 
Net investment income
   
12.0
     
11.4
 
Other operating revenues
   
0.9
     
0.8
 
Total operating revenues
   
719.6
     
755.8
 
Net realized investment gains
   
0.3
     
-
 
Other income, net
   
2.6
     
0.9
 
Total revenues
   
722.5
     
756.7
 
Benefits and expenses:
               
Claims incurred
   
620.9
     
626.7
 
Operating expenses
   
110.9
     
123.0
 
Total operating expenses
   
731.8
     
749.7
 
Interest expense
   
1.7
     
1.9
 
Total benefits and expenses
   
733.5
     
751.6
 
(Loss) income before taxes
   
(11.0
)
   
5.1
 
Income taxes (benefit) / expense
   
(6.7
)
   
1.7
 
Net (loss) income attributable to TSM
 
$
(4.3
)
 
$
3.4
 

Three Months Ended March 31, 2017 Compared to Three Months Ended March 31, 2016
 
Operating Revenues
 
Consolidated premiums earned, net for the three months ended March 31, 2017 decreased by $36.2 million, or 4.9%, to $702.3 million when compared to the three months ended March 31, 2016.  This decrease primarily reflects lower premiums in the Managed Care segment by $38.2 million mainly due to lower membership in the segment’s Medicaid and Commercial businesses.
 
Other Income, Net
 
The $1.7 million increase in consolidated other income reflects the collection of interest charged for late payment related to the current Medicaid contract.
 
Claims Incurred
 
Consolidated claims incurred decreased by $5.8 million, or 0.9%, to $620.9 million during the three months ended March 31, 2017 when compared to the claims incurred during the three months ended March 31, 2016, mostly due to lower claims in the Managed Care segment.  The decrease in Managed Care claims primarily reflects lower claims incurred in the segment’s Medicaid and Commercial businesses primarily driven by lower enrollment, offset in part by higher pharmacy claims trends in the Medicare and Medicaid businesses, higher Part B drugs in the Medicare business, and enhanced benefits in the Medicare 2017 offerings.  This decrease was also offset by higher claims incurred in the Life Insurance segment.  The consolidated loss ratio increased by 350 basis points to 88.4%.
 
Operating Expenses
 
Consolidated operating expenses during the three months ended March 31, 2017 decreased by $12.1 million, or 9.8%, to $110.9 million as compared to the operating expenses during the three months ended March 31, 2016.  The lower operating expenses are mostly the result of the decrease in the Health Insurance Providers Fee (HIP fee) of $10.8 million due to the 2017 tax holiday, and lower personnel costs.  For the three months ended March 31, 2017, the consolidated operating expense ratio decreased 80 basis points to 15.7%.
 
Income Taxes
 
Consolidated income taxes decreased by $8.4 million, to a benefit of $6.7 million for the three months ended March 31, 2017.  The year over year change in income taxes primarily results from a loss before taxes incurred in the 2017 period incurred in the Managed Care segment.
 
Managed Care Operating Results
 
   
Three months ended
March 31,
 
(dollar amounts in millions)
 
2017
   
2016
 
Operating revenues:
           
Medical premiums earned, net:
           
Commercial
 
$
205.1
   
$
215.5
 
Medicare
   
257.7
     
261.0
 
Medicaid
   
177.7
     
202.2
 
Medical premiums earned, net
   
640.5
     
678.7
 
Administrative service fees
   
5.6
     
6.3
 
Net investment income
   
3.9
     
3.5
 
Total operating revenues
   
650.0
     
688.5
 
Medical operating costs:
               
Medical claims incurred
   
587.3
     
596.3
 
Medical operating expenses
   
81.3
     
92.8
 
Total medical operating costs
   
668.6
     
689.1
 
Medical operating loss
 
$
(18.6
)
 
$
(0.6
)
Additional data:
               
Member months enrollment:
               
Commercial:
               
Fully-insured
   
1,013,205
     
1,096,282
 
Self-funded
   
507,167
     
543,026
 
Total Commercial
   
1,520,372
     
1,639,308
 
Medicare
   
363,727
     
364,427
 
Medicaid
   
1,173,273
     
1,221,892
 
Total member months
   
3,057,372
     
3,225,627
 
Medical loss ratio
   
91.7
%
   
87.9
%
Operating expense ratio
   
12.6
%
   
13.5
%

Three Months Ended March 31, 2017 Compared to Three Months Ended March 31, 2016
 
Medical Operating Revenues
 
Medical premiums earned for the three months ended March 31, 2017 decreased by $38.2 million, or 5.6%, to $640.5 million when compared to the medical premiums earned during the three months ended March 31, 2016.  This decrease is principally the result of the following:
 
Medical premiums generated by the Medicaid business amounted to $177.7 million, $24.5 million, or 12.1% lower when compared to the medical premiums earned during the three months ended March 31, 2016.  Decrease primarily reflects lower fully-insured member months enrollment by approximately 48,600 lives and the 4% decrease in average premium rates that went into effect July 1, 2016. Also contributing to the lower premiums during this period are last year’s partial reversal of the accrued 2.5% excess profit of $3.6 million and to $2.6 million related to the suspension of the HIP fee pass-through as a result of the 2017 moratorium.
 
Medical premiums generated by the Commercial business decreased by $10.4 million, or 4.8%, to $205.1 million.  This fluctuation primarily reflects lower fully-insured member enrollment during the quarter of approximately 83,000 member months and $3.5 million related to the suspension of the HIP fee pass-through; offset by an increase in average premium rates of approximately 5%.
 
Medical premiums generated by the Medicare business decreased by $3.3 million, or 1.3%, to $257.7 million, primarily reflecting lower average premium rates due to a change in membership mix, with the current period presenting a higher concentration of non-dual individuals and groups and a reduction in the 2017 Medicare reimbursement rates.
 
Medical Claims Incurred
 
Medical claims incurred during the three months ended March 31, 2017 decreased by $9.0 million, or 1.5%, to $587.3 million when compared to the three months ended March 31, 2016.  The medical loss ratio (MLR) of the segment increased 380 basis points during the 2017 period, to 91.7%.  This fluctuation is primarily attributed to the net effect of the following:
 
The medical claims incurred in the Medicaid business decreased by $8.4 million, or 4.6%, during the 2017 period, mostly driven by lower enrollment offset by higher utilization. The MLR, at 97.8%, was 770 basis point higher than the same period last year.  The higher MLR primarily reflects increased pharmacy and outpatient claim trends and the lower premium rates that went into effect July 1, 2016.
 
The medical claims incurred of the Commercial business decreased by $7.6 million, or 4.3%, during the 2017 period mostly driven by lower enrollment. The MLR, at 83.5%, was 70 basis point higher than the same month last year.  Adjusting for the effect of prior period reserve developments, the Commercial MLR would have been 83.3%, 240 basis points lower than the adjusted MLR for last year primarily reflecting claim trends that are lower than our premium trends following the continuity of our underwriting discipline.
 
The medical claims incurred of the Medicare business increased by $7.0 million, or 3.0%, during the 2017 period and its MLR increased by 390 basis points, to 94.0%.  Adjusting for the effect of prior period reserve developments in 2017 and 2016 and moving the risk score revenue adjustments to their corresponding period, the Medicare MLR would have been approximately 95.6% this quarter, about 280 basis points higher than last year, primarily reflecting higher trends in Part B drugs, pharmacy benefits and the improvement of benefits in 2017 products taking advantage of the HIP fee moratorium.
 
Medical Operating Expenses
 
Medical operating expenses for the three months ended March 31, 2017 decreased by $11.5 million, or 12.4 %, to $81.3 million when compared to the three months ended March 31, 2016.  The operating expense ratio decreased by 90 basis points to 12.6% in 2017.  The lower operating expenses and expense ratio are mostly the result of the decrease in the HIP Fee of $10.7 million due to the 2017 moratorium as well as lower personnel costs.
 
Life Insurance Operating Results
 
   
Three months ended
March 31,
 
(dollar amounts in millions)
 
2017
   
2016
 
Operating revenues:
           
Premiums earned, net:
           
Premiums earned
 
$
41.8
   
$
39.8
 
Assumed earned premiums
   
0.9
     
1.5
 
Ceded premiums earned
   
(2.2
)
   
(2.2
)
Premiums earned, net
   
40.5
     
39.1
 
Net investment income
   
6.1
     
5.9
 
Total operating revenues
   
46.6
     
45.0
 
Operating costs:
               
Policy benefits and claims incurred
   
23.7
     
21.4
 
Underwriting and other expenses
   
19.0
     
18.0
 
Total operating costs
   
42.7
     
39.4
 
Operating income
 
$
3.9
   
$
5.6
 
Additional data:
               
Loss ratio
   
58.5
%
   
54.7
%
Operating expense ratio
   
46.9
%
   
46.0
%

Three Months Ended March 31, 2017 Compared to Three Months Ended March 31, 2016
 
Operating Revenues
 
Premiums earned, net increased by $1.4 million, or 3.6% to $40.5 million as the result of premium growth in the segment’s Individual Life and Cancer lines of business, as well as growth in the Costa Rica operations.
 
Policy Benefits and Claims Incurred
 
Policy benefits and claims incurred increased by $2.3 million, or 10.7%, to $23.7 million, mostly as the result of the higher volume of business during the year, particularly in the Individual Life and Cancer lines of business and higher number of claims paid.  The loss ratio for the period increased to 58.5% in 2017, or 380 basis points, reflecting the higher volume in the Cancer line of business, which has a higher loss ratio, as well as to a higher claims experience in this particular line of business.
 
Underwriting and Other Expenses
 
Increase in underwriting and other expenses of $1.0 million, or 5.6%, to $19.0 million mostly reflects higher commissions following the segment’s premium growth mentioned above.   In addition, the segment has incurred in higher development and marketing expenses related to the expansion of the Costa Rica operations.  As a result, the segment’s operating expense ratio increased to 46.9%, 90 basis points.
 
Property and Casualty Insurance Operating Results

   
Three months ended
March 31,
 
(dollar amounts in millions)
 
2017
   
2016
 
Operating revenues:
           
Premiums earned, net:
           
Premiums written
 
$
27.4
   
$
27.6
 
Premiums ceded
   
(10.1
)
   
(10.4
)
Change in unearned premiums
   
4.4
     
4.1
 
Premiums earned, net
   
21.7
     
21.3
 
Net investment income
   
1.9
     
1.9
 
Total operating revenues
   
23.6
     
23.2
 
Operating costs:
               
Claims incurred
   
10.6
     
9.7
 
Underwriting and other expenses
   
10.9
     
11.4
 
Total operating costs
   
21.5
     
21.1
 
Operating income
 
$
2.1
   
$
2.1
 
Additional data:
               
Loss ratio
   
48.8
%
   
45.5
%
Operating expense ratio
   
50.2
%
   
53.5
%

Three Months Ended March 31, 2017 Compared to Three Months Ended March 31, 2016
 
Operating Revenues
 
Total premiums written decreased by $0.2 million, or 0.7%, to $27.4 million, driven by lower sales of Commercial package products.
 
The premiums ceded to reinsurers decreased by $0.3 million, or 2.9%, mostly reflecting lower premiums written in Commercial insurance products.
 
The change in unearned premiums presents an increase of $0.3 million mostly reflecting the segments lower premiums written in 2017 and lower cost.
 
Claims Incurred
 
Claims incurred increased by $0.9 million, or 9.3%, to $10.6 million.  The loss ratio increased by 330 basis points, to 48.8% during this period, primarily as a result of an unfavorable loss experience in the Commercial and Personal Auto lines of business.
 
Underwriting and Other Expenses
 
Underwriting and other operating expenses decreased by $0.5 million, or 4.4%, to $10.9 million mostly due to lower personnel costs .  The operating expense ratio was 50.2%, 330 basis points lower than last year.
 
Liquidity and Capital Resources
 
Cash Flows
 
A summary of our major sources and uses of cash for the periods indicated is presented in the following table:

   
Three months ended
March 31,
 
(dollar amounts in millions)
 
2017
   
2016
 
Sources (uses) of cash:
           
Cash provided by operating activities
 
$
131.0
   
$
31.3
 
Net proceeds (purchases) of investment securities
   
0.4
     
(108.9
)
Net capital expenditures
   
(3.3
)
   
(1.5
)
Proceeds from long-term borrowings
   
24.3
     
-
 
Payments of long-term borrowings
   
(24.7
)
   
(0.4
)
Proceeds from policyholder deposits
   
4.1
     
3.4
 
Surrenders of policyholder deposits
   
(4.9
)
   
(2.9
)
Repurchase and retirement of common stock
   
-
     
(8.0
)
Other
   
(11.4
)
   
1.6
 
Net increase (decrease) in cash and cash equivalents
 
$
115.5
   
$
(85.4
)

Cash flow from operating activities increased by $99.7 million for the three months ended March 31, 2017 as compared to the three months ended March 31, 2016, principally due to an increase in premium collections of $67.1 million, lower claims paid by $16.5 million and a decrease in cash paid to suppliers and employees of $14.4 million.   The higher premium collections follow the collection in advance of the April 2017 Medicare premiums from CMS.
 
Net proceeds from sales of investments securities primarily results from net cash flows received from the sales, maturities, and purchases of investment securities during the period following our asset/liability management strategy.
 
During the three months ended March 31, 2017, we received $24.3 million from a commercial bank in Puerto Rico related with a credit agreement entered into in December 2016.  These proceeds were used during the 2017 period to prepay the outstanding principal amount of $24.0 million of the 6.6% senior unsecured notes.
 
There were no repurchase and retirement of common stock during the three months ended March 31, 2017.
 
The fluctuation in the Other uses/sources of cash is attributed to changes in the amount of outstanding checks over bank balances.
 
Financing and Financing Capacity
 
We have several short-term facilities available to address timing differences between cash receipts and disbursements.  These short-term facilities are mostly in the form of arrangements to sell securities under repurchase agreements.  As of March 31, 2017, we had $60.0 million of available credit under these facilities.  There are no outstanding short-term borrowings under these facilities as of March 31, 2017.
 
On December 21, 2005, we issued and sold $60.0 million of our 6.6% senior unsecured notes originally due December 2020 (the 6.6% notes).  These unsecured notes were paid in full on January 11, 2017.
 
On December 28, 2016, TSM entered into a $35.5 million credit agreement with a commercial bank in Puerto Rico. The agreement consists of three term loans: (i) Term Loan A in the principal amount of $11.2 million, (ii) Term Loan B in the principal amount of $20.2 million and (iii) Term Loan C in the principal amount of $4.1 million. Term Loan A matures in October 2023 while the Term Loans B and C mature in January 2024.  Term Loan A was used to refinance the previous $41.0 million secured loan payable with the same commercial bank in Puerto Rico.  Proceeds from Term Loans B and C were received on January 11, 2017 and were used to prepay the outstanding principal amount plus accrued interest of the 6.6% senior unsecured notes due January 2021 ($24.0 million).  Pursuant to the credit agreement, interest is payable on the outstanding balance of the Loan at the following annual rate: (i) 1% over LIBOR for Term Loan A, (ii) 2.75% over LIBOR for Term Loan B, and (iii) 3.25% over LIBOR for Term Loan C.  The loan includes certain financial and non-financial covenants, which are customary for this type of facility, including but not limited to, restrictions on the granting of certain liens, limitations on acquisitions and limitations on changes in control and dividends.  Failure to meet these covenants may trigger the accelerated payment of the outstanding balance.  As of March 31, 2017 we are in compliance with these covenants.
 
On March 11, 2016 TSS entered into a $30.0 million revolving loan agreement with a commercial bank in Puerto Rico. This unused line of credit had an interest rate of LIBOR plus 220 basis points and includes certain financial and non-financial covenants that are customary for this type of facility. This revolving loan agreement matured on March 11, 2017, and was not renewed.
 
On April 18, 2017, TSA entered into a $10.0 million revolving loan agreement with a commercial bank in Puerto Rico. This unused line of credit has an interest rate of 30-day LIBOR plus 25 basis points, and contains certain financial and non-financial covenants that are customary for this type of facility.
 
We anticipate that we will have sufficient liquidity to support our currently expected needs.
 
Further details regarding the senior unsecured notes and the credit agreements are incorporated by reference to “Item 7.—Management Discussion and Analysis of Financial Condition and Results of Operations” included in our Annual Report on Form 10-K for the year ended December 31, 2016.
 
Item 3.
Quantitative and Qualitative Disclosures about Market Risk
 
We are exposed to certain market risks that are inherent in our financial instruments, which arise from transactions entered into in the normal course of business.  We have exposure to market risk mostly in our investment activities.  For purposes of this disclosure, “market risk” is defined as the risk of loss resulting from changes in interest rates and equity prices.  No material changes have occurred in our exposure to financial market risks since December 31, 2016.  A discussion of our market risk is incorporated by reference to “Item 7A. Quantitative and Qualitative Disclosures about Market Risk” of our Annual Report on Form 10-K for the year ended December 31, 2016.
 
Item 4.
Controls and Procedures
 
Evaluation of Disclosure Controls and Procedures
 
In connection with the preparation of this Quarterly Report on Form 10-Q, management, under the supervision and with the participation of the chief executive officer and chief financial officer, conducted an evaluation of the effectiveness of the “disclosure controls and procedures” (as such term is defined under Exchange Act Rule 13a-15(e)) of the Corporation and its subsidiaries. Disclosure controls and procedures are designed to ensure that information required to be disclosed in reports filed or submitted under the Exchange Act is recorded, processed, summarized and reported within the time periods specified in Securities and Exchange Commission rules and forms and that such information is accumulated and communicated to management, including the chief executive officer and chief financial officer, to allow timely decisions regarding required disclosures. A control system, no matter how well conceived and operated, can provide only reasonable, not absolute, assurance that the objectives of the control system are met.  There are inherent limitations to the effectiveness of any system of disclosure controls and procedures, including the possibility that judgments in decision-making can be faulty, and breakdowns as a result of simple errors or mistake. Accordingly, even effective disclosure controls and procedures can only provide reasonable assurance of achieving their control objectives.  The design of any system of controls also is based in part upon certain assumptions about the likelihood of future events, and there can be no assurance that any design will succeed in achieving its stated goals under all potential future conditions.
 
Based on this evaluation, our chief executive officer and chief financial officer have concluded that as of March 31, 2017, which is the end of the period covered by this Quarterly Report on Form 10-Q, our disclosure controls and procedures are effective to a reasonable level of assurance.
 
There were no significant changes in our 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.
 
Changes in Internal Controls Over Financial Reporting
 
No changes in our internal control over financial reporting (as such term is defined in Exchange Act Rule 13a-15(f)) occurred during the fiscal quarter ended March 31, 2017 that materially affected, or is reasonably likely to materially affect, our internal control over financial reporting.

Part II – Other Information
 
Item 1.
Legal Proceedings
 
For a description of legal proceedings that have experienced significant developments during this quarter, see note 13 to the unaudited condensed consolidated financial statements included in this quarterly report on Form 10-Q.
 
Item 1A.
Risk Factors
 
For a description of our risk factors see Item 1A of Part I of our Annual Report on Form 10-K for the year ended December 31, 2016 .
 
The following text updates the disclosure included in Item 1A of Part I of our Annual Report on Form 10-K for the year ended December 31, 2016, under the sub-caption “ The health care reform law and the implementation of that law could have a material adverse effect on our business, financial condition, cash flows, or results of operations.
 
On January 20, 2017, President Trump signed an Executive Order directing federal agencies with authorities and responsibilities under the ACA to waive, defer, grant exemptions from, or delay the implementation of any provision of the ACA that would impose a fiscal or regulatory burden on states, individuals, healthcare providers, health insurers, or manufacturers of pharmaceuticals or medical devices. Further, in January 2017, Congress voted to adopt a budget resolution for fiscal year 2017, or the Budget Resolution, that authorizes the implementation of legislation that would repeal portions of the ACA. Following the passage of the Budget Resolution, on March 6, 2017, the U.S. House of Representatives introduced legislation known as the American Health Care Act, which, if enacted, would amend or repeal significant portions of the ACA. Among other changes, the American Health Care Act would sunset the annual insurance industry assessment as of December 31, 2017, essentially eliminate the individual and employer mandates by eliminating   penalties and providing retroactive relief for failing to maintain or provide minimum essential coverage, and permit insurers to charge individuals a 30% surcharge on premiums for failing to demonstrate continuous coverage. The American Health Care Act would also make significant changes to Medicaid by, among other things, making the ACA Medicaid expansion optional for states, repealing the ACA requirement that state Medicaid plans provide the same essential health benefits that are required by plans available through the exchanges, implementing a per capita cap on federal payments to states beginning in fiscal year 2020, and changing certain eligibility requirements.  On May 4, 2017, the U.S. House of Representatives approved the American Health Care Act to repeal portions of the ACA. The American Health Care Act will now be considered by the U.S. Senate. While it is uncertain when or if the provisions in the American Health Care Act will become law, or the extent to which any such changes may impact our business, it is clear that Congress is taking concrete steps to repeal and replace certain aspects of the ACA.
 
Item 2.
Unregistered Sales of Equity Securities and Use of Proceeds
 
Not applicable.
 
Item 3.
Defaults Upon Senior Securities
 
Not applicable.
 
Item 4.
Mine Safety Disclosures
 
Not applicable.
 
Item 5.
Other Information
 
Not applicable.
 
Item 6.
Exhibits
 
Exhibits
Description
   
3(i)(c)
Articles of Incorporation of Triple-S Management Corporation, incorporated by reference to Exhibit 3(i)(c) to TSM’s Quarterly Report on Form 10-Q for the quarter ended March 31, 2008 (File No. 001-33865).
   
Amendments to Article Tenth and Thirteenth of the Amended and Restated Articles of Incorporation of Triple-S Management Corporation.
   
Composite Amended and Restated Articles of Incorporation of Triple-S Management Corporation.
   
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, 2017 and 2016 has been omitted as the detail necessary to determine the computation of earnings per share can be clearly determined from the material contained in Part I of this Quarterly Report on Form 10-Q.
   
Certification of the President and Chief Executive Officer required by Rule 13a-14(a)/15d-14(a).
   
Certification of the Executive Vice President and Chief Financial Officer required by Rule 13a-14(a)/15d-14(a).
   
Certification of the President and Chief Executive Officer required pursuant to 18 U.S.C Section 1350.
   
Certification of the Executive Vice President and Chief Financial Officer required pursuant to 18 U.S.C Section 1350.
 
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.
 
*
Filed herein.
 
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 9, 2017
 
By:
/s/ Roberto García-Rodríguez
 
       
Roberto García-Rodríguez
 
       
President and Chief Executive Officer
           
Date:
May 9, 2017
 
By:
/s/ Juan J. Román-Jiménez
 
       
Juan J. Román-Jiménez
 
       
Executive Vice President and Chief Financial Officer
 
 
43


Exhibit 3(i)(d)
 
TRIPLE-S MANAGEMENT CORPORATION

CERTIFICATE OF AMENDMENT TO THE
AMENDED AND RESTATED ARTICLES OF INCORPORATION

TRIPLE-S MANAGEMENT CORPORATION (the “Corporation”), a corporation organized and existing under the laws of the Commonwealth of Puerto Rico, does hereby certify:

FIRST : That at a meeting of the Board of Directors of the Corporation, duly held and convened on February 14, 2017, resolutions were duly adopted approving proposed amendments (the “Amendments”) to Paragraphs A and C of Article TENTH and Paragraph B of Article THIRTEENTH to the Corporation’s Amended and Restated Articles of Incorporation and declaring said Amendments advisable in the form set forth herein.

SECOND : That at the annual meeting of shareholders of the Corporation held on April 28, 2017, the inspectors of election appointed for the purpose of conducting and tabulating the votes of the shareholders for and against the adoption of the Amendments, executed and delivered a certificate to the effect that more than a majority of the issued and outstanding stock of the Corporation entitled to vote on the Amendments voted in favor of the said Amendments.

THIRD : That the Amendments have been adopted in accordance with the applicable provisions of Article 8.02(B) of the Puerto Rico General Corporations Law of 2009, as amended.

FOURTH : That Paragraph A of Article TENTH of the Corporation’s Amended and Restated Articles of Incorporation is hereby amended in its entirety to read as follows:

“A. The business affairs of the Corporation shall be managed under the direction of a Board of Directors consisting of not less than seven (7) Directors, nor more than thirteen (13) Directors.”

FIFTH : That Paragraph C of Article TENTH of the Corporation’s Amended and Restated Articles of Incorporation is hereby amended in its entirety to read as follows:

“C. Every director will perform his/her duties until his/her successor is duly elected and in possession of his/her position.”

SIXTH : That Paragraph B of Article THIRTEENTH of the Corporation’s Amended and Restated Articles of Incorporation is hereby amended in its entirety to read as follows:

“B. The Board of Directors of the Corporation shall have the power to amend the Bylaws of the Corporation by the vote of a majority of the whole Board of Directors of the Corporation. The shareholders of the Corporation shall not have the power to amend the Bylaws of the Corporation unless such amendment shall be approved by the holders of at least a majority of the then issued and outstanding shares of capital stock entitled to vote thereon. Notwithstanding anything contained in these Articles of Incorporation of the Corporation to the contrary, the approval of BCBSA (unless each and every License Agreement with BCBSA to which the Corporation or its subsidiaries shall be subject shall have been terminated) shall be required to amend Section 2.8, the last sentence of Section 3.1, the first sentence of Section 3.4(a), Section 3.13, Section 3.14(b) and the BCBSA approval requirement contained in Section 6.6 of the By-Laws of the Corporation and the BCBSA approval requirement contained in this Article THIRTEENTH. For purposes of this Section B of Article THIRTEENTH, the term “whole Board of Directors of the Corporation” means the total number of Directors which the Corporation would have as of the date of such determination if the Board of Directors of the Corporation had no vacancies.”
 

IN WITNESS WHEREOF , Triple-S Management Corporation has caused its corporate seal to be hereunder affixed and this Certificate to be signed by Daniel E. Gonzàlez-Ortiz, as Assistant Corporate Secretary of the Corporation, this 8 th day of May, 2017.

[Corporate Seal]
 
 
/s/ Daniel E. Gonzàlez-Ortiz
 
Daniel E. Gonzàlez-Ortiz
 
Assistant Corporate Secretary
 
 


Exhibit (i)(e)
 
COMPOSITE AMENDED AND RESTATED
ARTICLES OF INCORPORATION
OF
TRIPLE-S MANAGEMENT CORPORATION

TRIPLE-S MANAGEMENT CORPORATION , a corporation organized and existing under the laws of the Commonwealth of Puerto Rico, hereby certifies, as follows:

1. The name of the corporation is Triple-S Management Corporation and its original Articles of Incorporation were filed with the Secretary of State of the Commonwealth of Puerto Rico on October 9, 1996, Registration Number 95,905.

2. The following Composite Amended and Restated Articles of Incorporation integrate and update the provisions of the Amended and Restated Articles of Incorporation of Triple-S Management Corporation, to include the amendments approved by the shareholders of the Corporation at the annual meeting of shareholders held on April 28, 2017.

3. The text of the Amended and Restated Articles of Incorporation of Triple-S Management Corporation, as amended with the approval of the shareholders, read in their entirety as follows:

FIRST: `
The name of this corporation is TRIPLE-S MANAGEMENT CORPORATION .

SECOND:
The physical address of the designated office of the Corporation is 1441 F.D. Roosevelt Avenue, San Juan, Puerto Rico 00920.

THIRD:
The Corporation’s registered agent will be the Corporation itself, Triple-S Management Corporation. The address of such resident agent is 1441 F.D. Roosevelt Avenue, San Juan, Puerto Rico 00920.

FOURTH:
The nature of the business or purposes to be conducted or promoted by the Corporation is to engage in any lawful act or activity for which corporations may be organized under the General Corporation Law of the Commonwealth of Puerto Rico, as from time to time amended (the “GCLPR”).
 
FIFTH:
A.          The total number of shares of all classes of stock which the Corporation shall have authority to issue is Three Hundred Million (300,000,000) shares, consisting of (a)(1) one hundred million (100,000,000) shares of Class A Common Stock, par value $1.00 per share (the “Class A Common Stock”), and (2) one hundred million (100,000,000) shares of Class B Common Stock, par value $1.00 per share (the “Class B Common Stock”), and (b) One Hundred Million (100,000,000) shares of Preferred Stock, par value $1.00 per share (the “Preferred Stock”). On the effective date of this provision, all shares of common stock outstanding prior thereto shall be automatically converted into Class A Common Stock. As used herein the term “Common Stock” shall mean the Class A Common Stock and Class B Common Stock. The rights, privileges and ownership interests represented by each share of Class A Common Stock shall be identical in every respect to the rights, privileges and ownership interests represented by each share of Class B Common Stock, except as otherwise expressly provided below.
 
1.            Voting Rights. Each holder of a share of Common Stock shall be entitled to one vote for each share standing in such holder’s name on the books of the Corporation irrespective of the class or series thereof, and all shares of all classes and series of Common Stock shall vote together as a single class; provided, that any amendment to these Amended and Restated Articles of Incorporation affecting any of the rights, privileges or ownership interests of the Class A Common Stock or the Class B Common Stock, including but not limited to the rights set forth in Attachments B and C hereto, shall require the affirmative vote of a majority of the shares outstanding of each of the Class A Common Stock and the Class B Common Stock.
 

2.            Dividends . When and as dividends are declared or paid or distributions are made upon Common Stock, whether payable in cash, in property or in securities of the Corporation, the holders of Common Stock shall be entitled to share equally, share for share, in such dividends and distributions. Dividends declared and payable in shares of Common Stock shall be declared and be payable at the same rate in each class of stock. Dividends on shares of Class A Common Stock shall be payable in shares of Class A Common Stock and the dividends on shares of Class B Common Stock shall be payable in shares of Class B Common Stock.

3.            Conversion . Holders of the Class A Common Stock shall be entitled to the conversion rights set forth in Attachment B hereto.

4.            Anti-Dilution Rights . Holders of the Class B Common Stock shall be entitled to the anti-dilution rights set forth in Attachment C hereto.

SIXTH:
The shares of capital stock of the Corporation shall be subject to the transfer restrictions set forth in Attachment A to these Articles of Incorporation. Such transfer restrictions are being adopted in order for the Corporation to comply with the License Agreement between Blue Cross and Blue Shield Association (or its then successor) (the “BCBSA”) and the Corporation and related License Agreements between the subsidiaries of the Corporation and BCBSA.
 
SEVENTH:
A.            At every annual or special meeting of shareholders of the Corporation, every holder of shares of Common Stock shall be entitled to one (1) vote for each share of Common Stock standing in his or her name on the books of the Corporation.
 
B.              There shall be no cumulative voting by shareholders of any class or series of capital stock as may be set forth in the PRGCL or any other law, regulation, decree or agreement.

EIGHTH:
A.           The Corporation shall be required, to the maximum extent permitted by the GCLPR, to indemnify each of its directors, officers and employees and any director, officer or employee who is or was serving at the request of the Corporation as a director, officer, employee, or agent of another corporation, partnership, joint venture, trust, limited liability company or other enterprise against expenses, judgments, fines, settlements, and other amounts actually and reasonably incurred in connection with any proceeding arising due to the fact that any such person is or was a director, an officer or an employee of the Corporation or is or was serving at the request of the Corporation as a director, officer, employee, or agent of another corporation, partnership, joint venture, trust, limited liability company or other enterprise.
 
B.                The Corporation may, in its absolute discretion, up to the maximum extent permitted by the GCLPR, indemnify each person who is not required to be indemnified under Section A above against expenses, judgments, fines, settlements, and other amounts actually and reasonably incurred in connection with any proceeding arising by reason of the fact that any such person is or was serving or has agreed to serve the Corporation in any capacity, other than as a director, officer or employee, to the extent that the Corporation is required or permitted to indemnify directors, officers or employees under Section A above.
 
C.                The Corporation shall indemnify any director, officer, employee, or other agent of the Corporation against expenses, judgments, fines, settlements, and other amounts actually and reasonably incurred in connection with any proceeding arising by reason of the fact that any such person is or was a trustee, investment manager, or other fiduciary under any employee benefit plan of the Corporation.
 

D.              To the extent permitted by the GCLPR and applicable law, expenses incurred in defending any proceeding in the case described in Sections A and C above shall be advanced (and in the case of Section B may be advanced) by the Corporation prior to the final disposition of such proceeding upon receipt of any undertaking by or on behalf of such person to repay such amount if it shall be determined ultimately that he or she is not entitled to be indemnified by the Corporation. Additionally, the Corporation shall reimburse attorneys’ fees and other reasonable related expenses incurred by any person in enforcing such person’s indemnification rights described in Section A above if it shall ultimately be determined that such person is entitled to such indemnification by the Corporation.
 
E.              The indemnification and the advancement of expenses provided by this Article EIGHTH shall not be exclusive of any other rights to which those seeking indemnification or advancement of expenses may be entitled under any statute, these Articles of Incorporation, the Bylaws or any agreement, vote of shareholders or disinterested directors, policy of insurance or otherwise, both as to action in their official capacity and as to action in another capacity while holding their respective offices, and shall not limit in any way any right which the Corporation may have to provide additional indemnification with respect to the same or different persons or classes of persons. The indemnification and advancement of expenses provided by this Article EIGHTH shall continue as to a person who has ceased to serve in a capacity that entitles such person to indemnity under this Article EIGHTH (an “Indemnifiable Capacity”) and shall inure to the benefit of the heirs, executors and administrators of such a person.

F.               Upon resolution passed by the Board of Directors, the Corporation may purchase and maintain insurance on behalf of any person who is or was serving in an Indemnifiable Capacity against any liability asserted against such person and incurred by such person in any such capacity, or arising out of such person’s status as such, whether or not the Corporation would have the power to indemnify such person against such liability under the provisions of this Article EIGHTH. Notwithstanding anything in this Article EIGHTH to the contrary: (i) the Corporation shall not be obligated to indemnify any person serving in an Indemnifiable Capacity for any amounts which have been paid directly to such person by any insurance maintained by the Corporation; and (ii) any indemnification provided pursuant to this Article EIGHTH, (A) shall not be used as a source of contribution to, or as a substitute for, or as a basis for recoupment of any payments pursuant to, any indemnification obligation or insurance coverage which is available from any other enterprise, and (B) shall become operative, and payments shall be required to be made thereunder, only in the event and to the extent that the amounts in question have not been fully paid by any indemnification obligation or insurance coverage which is available from any other enterprise.

G.              The rights granted or created hereby shall be vested in each person entitled to indemnification hereunder as a bargained-for contractual condition of such person’s serving or having served in an Indemnifiable Capacity and, while this Article EIGHTH may be amended or repealed, no such amendment or repeal shall release, terminate or adversely affect the rights of such person under this Article EIGHTH with respect to any act taken or the failure to take any act by such person prior to such amendment or repeal or with respect to any action, suit or proceeding with respect to such act or failure to act filed after such amendment or repeal.
 

H.              If any provision of this Article EIGHTH or the application of any such provision to any person or circumstance is held invalid, illegal or unenforceable for any reason whatsoever, the remaining provisions of this Article EIGHTH and the application of such provision to other persons or circumstances shall not be affected thereby and, to the fullest extent possible, the court finding such provision invalid, illegal or unenforceable shall modify and construe the provision so as to render it valid and enforceable as against all persons or entities and to give the maximum possible protection to persons subject to indemnification hereby within the bounds of validity, legality and enforceability. Without limiting the generality of the foregoing, if any person who is or was serving in an Indemnifiable Capacity is entitled under any provision of this Article EIGHTH to indemnification by the Corporation for some or a portion of the judgments, amounts paid in settlement, attorneys’ fees, ERISA excise taxes or penalties, fines or other expenses actually and reasonably incurred by any such person in connection with any threatened, pending or completed action, suit or proceeding (including, without limitation, the investigation, defense, settlement or appeal of such action, suit or proceeding), whether civil, criminal, administrative, investigative or appellate, but not, however, for all of the total amount thereof, the Corporation shall nevertheless indemnify such person for the portion thereof to which such person is entitled.

NINTH:
A director of the Corporation shall not be personally liable to the Corporation or its shareholders for monetary damages for breach of fiduciary duty as a director, except to the extent such exemption from liability or limitation thereof is not permitted under the GCLPR. In no event shall any director be deemed to breach any fiduciary duty or other obligation owed to any shareholders of the Corporation or any other person by reason of (i) his or her failure to vote for (or by reason of such director’s vote against) any proposal or course of action that in such director’s judgment would breach any requirement imposed on the Corporation or any subsidiary or affiliate of the Corporation by the BCBSA or could lead to termination of any license granted by the BCBSA to the Corporation or any subsidiary or affiliate of the Corporation, or (ii) his or her decision to vote in favor of any proposal or course of action that in such director’s judgment is necessary to prevent a breach of any requirement imposed by the BCBSA or could prevent termination of any license granted by the BCBSA to the Corporation or any subsidiary or affiliate of the Corporation. Any repeal or modification of the foregoing provisions of this Article NINTH by the shareholders of the Corporation shall not adversely affect any right or protection of a director of the Corporation existing at the time of such repeal or modification.
 
TENTH:
 
A.
The business and affairs of the Corporation shall be managed under the direction of a Board of Directors consisting of not less than seven (7) Directors, nor more than thirteen (13) Directors.

B.
Subject to the terms of this paragraph, the Board of Directors shall be divided into three groups, respectively designated “Group 1,” “Group 2,” and “Group 3,” as nearly equal in number as possible and whose term expire at different times. Directors in each group shall be elected for a term ending on the date of the third annual meeting of shareholders following the annual meeting at which such director is elected. The Board of Directors may (i) reduce the size of each group of directors and (ii) nominate directors for shorter terms of office and assign such nominees to another group, in order to meet the requirements of the first sentence of this paragraph by the 2010 annual meeting of shareholders.

C.
Every director will perform his/her duties until his/her successor is duly elected and in possession of his/her position.
 
ELEVENTH:
The Corporation will exist in perpetuity.
 

TWELFTH:
 The Corporation reserves the right to amend any provision contained in these Articles of Incorporation, in the manner now or hereafter prescribed by the GCLPR or other applicable law and these Articles of Incorporation, and all rights conferred upon shareholders herein are granted subject to this reservation; provided, however, that notwithstanding anything contained in these Articles of Incorporation to the contrary, (1) the approval of BCBSA (unless each and every License Agreement with BCBSA to which the Corporation or its subsidiaries shall be subject shall have been terminated) and (2) the affirmative vote of the holders of at least three-fourths (3/4) of the issued and outstanding voting shares of capital stock of the Corporation (the “Supermajority Shareholder Vote”) shall be required to amend Article SIXTH (including the provisions of Attachment A hereto), Paragraph B of Article SEVENTH, Paragraph B of Article TENTH or the BCBSA approval requirement or the Supermajority Shareholder Vote requirement set forth in this first proviso of Article TWELFTH; and provided further, however, that (i) the requirement for Supermajority Shareholder Vote shall become ineffective and shall be of no further force and effect in the event that each and every License Agreement with BCBSA to which the Corporation or its subsidiaries shall be subject shall have been terminated; and (ii) the Supermajority Shareholder Vote shall not apply to (1) any amendment to Article SIXTH (including the provisions of Attachment A hereto), Paragraph B of Article SEVENTH, Paragraph B of Article TENTH or the BCBSA approval requirement or the Supermajority Shareholder Vote requirement set forth in the first proviso of Article TWELFTH to conform such Articles to a change to the terms of any License Agreement, or (2) any amendment to Article SIXTH (including the provisions of Attachment A hereto), Paragraph B of Article SEVENTH, Paragraph B of Article TENTH or the BCBSA approval requirement or the Supermajority Shareholder Vote requirement set forth in the first proviso of Article TWELFTH required or permitted by the BCBSA (whether or not constituting a change to the terms of any License Agreement). The affirmative vote of the holders of at least the percentage of the issued and outstanding capital stock entitled to vote thereon required by the GCLPR or other applicable law shall be required to amend any provisions of these Articles of Incorporation that shall not require the Supermajority Shareholder Vote under this Article TWELFTH.

THIRTEENTH:
A.               The Bylaws shall govern the management and affairs of the Corporation, the rights and powers of the directors, officers, employees and shareholders of the Corporation in accordance with its terms and shall govern the rights of all persons concerned relating in  any way to the Corporation except that if any provision in the Bylaws shall be irreconcilably inconsistent with any provision in these Articles of Incorporation, the provision in these Articles of Incorporation shall control.

B.               The Board of Directors of the Corporation shall have the power to amend the Bylaws of the Corporation by the vote of a majority of the whole Board of Directors of the Corporation. The shareholders of the Corporation shall not have the power to amend the Bylaws of the Corporation unless such amendment shall be approved by the holders of at least a majority of the then issued and outstanding shares of capital stock entitled to vote thereon. Notwithstanding anything contained in these Articles of Incorporation of the Corporation to the contrary, the approval of BCBSA (unless each and every License Agreement with BCBSA to which the Corporation or its subsidiaries shall be subject shall have been terminated) shall be required to amend Section 2.8, the last sentence of Section 3.1, the first sentence of Section 3.4(a), Section 3.13, Section 3.14(b) and the BCBS approval requirement contained in Section 6.6 of the By-Laws of the Corporation and the BCBSA approval requirement contained in this Article THIRTEENTH. For purposes of this Section B of Article THIRTEENTH, the term “whole Board of Directors of the Corporation” means the total number of Directors which the Corporation would have as of the date of such determination if the Board of Directors of the Corporation had no vacancies.
 
Approved on April 30, 2006 by the stockholders of the Corporation.
Amended on April 29, 2007 by the stockholders of the Corporation.
Amended on June 24, 2007 by the stockholders of the Corporation.
Amended on April 27, 2008 by the stockholders of the Corporation.
Amended on April 28, 2017 by the stockholders of the Corporation.
 

ATTACHMENT A TO AMENDED AND RESTATED
ARTICLES OF INCORPORATION
OF TRIPLE-S MANAGEMENT CORPORATION

RESTRICTION ON TRANSFER

SECTION 1 . The following defined words and definitions shall apply with respect to this Attachment A to the Corporation’s Articles of Incorporation (“Attachment A”) in which such defined words are used.

(a) “Affiliate” and “Associate” have the respective meanings ascribed to such terms in Rule 12b-2 of the General Rules and Regulations under the Exchange Act.

(b) a Person shall be deemed to “Beneficially Own,” be the “Beneficial Owner” of or have “Beneficial Ownership” of any capital stock of the Corporation:

(1) in which such Person shall then have a direct or indirect beneficial ownership interest which confers a profit, benefit or advantage but which does not constitute legal ownership or control;

(2) in which such Person shall have the right to acquire any direct or indirect beneficial ownership interest pursuant to any option or other agreement (either immediately or after the passage of time or the occurrence of any contingency);

(3) which such Person shall have the right to vote;

(4) in which such Person shall hold any other interest which would count in determining whether such Person would be required to file a Schedule 13D or Schedule 13G under Regulation 13D-G under the Exchange Act; or

(5) which shall be Beneficially Owned (under the concepts provided in the preceding clauses) by any affiliate or associate of the particular Person or by any other Person with whom the particular Person or any such affiliate or associate has any agreement, arrangement or understanding (other than customary agreements with and between underwriters and selling group members with respect to a bona fide public offering of securities) relating to the acquisition, holding, voting or disposing of any securities of the Corporation;

provided, however, that

(6) a Person shall not be deemed to Beneficially Own, be the Beneficial Owner of, or have Beneficial Ownership of Capital Stock by reason of possessing the right to vote if (i) such right arises solely from a revocable proxy or consent given to such Person in response to a public proxy or consent solicitation made pursuant to, and in accordance with, the applicable rules and regulations promulgated under the Exchange Act, and (ii) such Person is not the Excess Owner of any Excess Shares, is not named as holding a beneficial ownership interest in any Capital Stock in any filing on Schedule 13D or Schedule 13G, and is not an affiliate or associate of any such Excess Owner or named Person;

(7) a member of a national securities exchange or a registered depositary shall not be deemed to Beneficially Own, be the Beneficial Owner of or have Beneficial Ownership of Capital Stock held directly or indirectly by it on behalf of another Person (and not for its own account) solely because such member or depositary is the record holder of such Capital Stock, and (in the case of such member), pursuant to the rules of such exchange, such member may direct the vote of such Capital Stock without instruction on matters which are uncontested and do not affect substantially the rights or privileges of the holders of the Capital Stock to be voted, but is otherwise precluded by the rules of such exchange from voting such Capital Stock without instruction on either contested matters or matters that may affect substantially the rights or the privileges of the holders of such Capital Stock to be voted;
 

(8) a Person who in the ordinary course of business is a pledgee of Capital Stock under a written pledge agreement shall not be deemed to Beneficially Own, be the Beneficial Owner of or have Beneficial Ownership of such pledged Capital Stock solely by reason of such pledge until the pledgee has taken all formal steps which are necessary to declare a default or has otherwise acquired the power to vote or to direct the vote of such pledged Capital Stock, provided that:

(A) the pledge agreement is bona fide and was not entered into with the purpose nor with the effect of changing or influencing the control of the Corporation, nor in connection with any transaction having such purpose or effect, including any transaction subject to Rule 13d-3(b) promulgated under the Exchange Act; and

(B)  the pledge agreement does not grant to the pledgee the right to vote or to direct the vote of the pledged securities prior to the time the pledgee has taken all formal steps which are necessary to declare a default;

(9) a Person engaged in business as an underwriter or a placement agent for securities who enters into an agreement to acquire or acquires Capital Stock solely by reason of its participation in good faith and in the ordinary course of its business in the capacity of underwriter or placement agent in any underwriting or agent representation registered under the Securities Act, as a bona fide private placement, a resale under Rule 144A promulgated under the Securities Act, or in any foreign or other offering exempt from the registration requirements under the Securities Act shall not be deemed to Beneficially Own, be the Beneficial Owner of or have Beneficial Ownership of such securities until the expiration of forty (40) days after the date of such acquisition so long as (i) such Person does not vote such Capital Stock during such period, and (ii) such participation is not with the purpose or with the effect of changing or influencing control of the Corporation, nor in connection with or facilitating any transaction having such purpose or effect, including any transaction subject to Rule 13d-3(b) promulgated under the Exchange Act;

(10) if the Corporation shall sell shares in a transaction not involving any public offering, then each purchaser in such offering shall be deemed to obtain Beneficial Ownership in such offering of the shares purchased by such purchaser, but no particular purchaser shall be deemed to Beneficially Own or have acquired Beneficial Ownership or be the Beneficial Owner in such offering of shares purchased by any other purchaser solely by reason of the fact that all such purchasers are parties to customary agreements relating to the purchase of equity securities directly from the Corporation in a transaction not involving a public offering, provided that:

(A) all the purchasers are persons specified in Rule 13d-1(b)(1)(ii) promulgated under the Exchange Act;

(B)  the purchase is in the ordinary course of each purchaser’s business and not with the purpose nor with the effect of changing or influencing control of the Corporation, nor in connection with or as a participant in any transaction having such purpose or effect, including any transaction subject to Rule 13d-3(b) promulgated under the Exchange Act,

(C)  there is no agreement among or between any purchasers to act together with respect to the Corporation or its securities except for the purpose of facilitating the specific purchase involved; and

(D)  the only actions among or between any purchasers with respect to the Corporation or its securities subsequent to the closing date of the nonpublic offering are those which are necessary to conclude ministerial matters directly related to the completion of the offer or sale of the securities sold in such offering;
 

(11) the Share Escrow Agent shall not be deemed to be the Beneficial Owner of any Excess Share held by such Share Escrow Agent pursuant to an Excess Share Escrow Agreement, nor shall any such Excess Shares be aggregated with any other shares of Capital Stock held by affiliates or associates of such Share Escrow Agent; and

(12) a Person shall not be deemed to Beneficially Own, be the Beneficial Owner of, or have Beneficial Ownership of Capital Stock by reason of the fact that such Person shall have entered into an agreement with the Corporation pursuant to which such Person, or its associates or affiliates, shall, upon consummation of the transaction described in such agreement, acquire, directly or indirectly, all of the Capital Stock of the Corporation (by means of a merger, consolidation, stock purchase or otherwise), provided that:

(A) such agreement shall have been approved by a majority of the board (not including any director who is not Independent as to such matter) prior to the execution thereof by the Corporation;

(B)  neither such Person nor its associates or affiliates shall have been the Excess Owner of any Excess Shares immediately prior to the execution of such agreement;

(C) the consummation of the transaction described in such agreement shall be subject to the approval of the holders of Capital Stock of the Corporation entitled to vote thereon under the GCLPR or pursuant to other applicable law or the rules of the New York Stock Exchange, Inc. or any other national securities exchange or automated quotation system on which any of the Capital Stock shall then be listed or quoted; and

(D)  neither such Person nor its associates or affiliates shall have made any acquisition of Capital Stock after the execution of such agreement other than pursuant to the terms of such agreement.

Anything herein to the contrary notwithstanding, a Person shall continue to be deemed to Beneficially Own, be the Beneficial Owner of, and have Beneficial Ownership of, such Person’s Excess Shares which shall have been conveyed, or shall be deemed to have been conveyed, to the Share Escrow Agent in accordance with this Attachment A until such time as such Excess Shares shall have been sold by the Share Escrow Agent as provided in this Attachment A .

(c) “BCBSA” means Blue Cross and Blue Shield Association.

(d) “Capital Stock” means shares (or any basic unit) of any class or series of any equity security, voting or non-voting, common or preferred, which the Corporation may at any time issue or be authorized to issue.

(e) “Common Stock” means the shares of common stock of the Corporation.

(f) “Excess Owner” means a Person who Beneficially Owns Excess Shares.

(g) “Excess Shares” means (i) with respect to any Institutional Investor, all the shares of Capital Stock Beneficially Owned by such Institutional Investor in excess of the Institutional Investor Ownership Limit, (ii) with respect to any Noninstitutional Investor, all the shares of Capital Stock Beneficially Owned by such Noninstitutional Investor in excess of the Noninstitutional Investor Ownership Limit, and (iii) with respect to any Person, all the shares of Capital Stock Beneficially Owned by such Person in excess of the General Ownership Limit. All Excess Shares shall be deemed to be issued and outstanding shares of Capital Stock even when subject to or held pursuant to this Attachment A.
 

(h) “Exchange Act” means the Securities Exchange Act of 1934, as amended or supplemented, and any other federal law which the Board of Directors of the Corporation shall reasonably judge to have replaced or supplemented the coverage of the Exchange Act.

(i) “GCLPR” means the General Corporation Law of the Commonwealth of Puerto Rico.

(j) “General Ownership Limit” means (i) that number of shares of Common Stock one share lower than the number of shares of Common Stock which would represent 20% of all shares of Common Stock issued and outstanding at the time of determination, or (ii) any combination of shares of Capital Stock in any series or class that represents 20% of the ownership interest in the Corporation at the time of determination. So long as Common Stock shall be the only class of Capital Stock issued by the Corporation, the General Ownership Limit shall be irrelevant for purposes of this Attachment A because the Institutional Investor Ownership Limit shall exclusively determine whether any shares of Common Stock owned by any Institutional Investor constitute Excess Shares and the Noninstitutional Investor Ownership Limit shall exclusively determine whether any shares of Common Stock owned by any Noninstitutional Investor constitute Excess Shares. If, however, the Corporation were to issue a series of Preferred Stock or other class of Capital Stock other than Common Stock, then (a) shares Beneficially Owned by an Institutional Investor in excess of either the Institutional Investor Ownership Limit or the General Ownership Limit would constitute Excess Shares, and (b) shares Beneficially Owned by a Noninstitutional Investor in excess of either the Noninstitutional Investor Ownership Limit or the General Ownership Limit would constitute Excess Shares.

(k) “Independent” means a person who, at any given time, shall (i) not be a Major Participant (as defined in Section 1(o) of this Attachment A), (ii) not have been nominated to the Board of Directors of the Corporation at the initiative of a Major Participant, (iii) not have announced a commitment to any proposal made by a Major Participant that has not been approved by a majority of the board (not including any director who is not Independent as to such matter), and not have been determined by a majority of the board (not including any director who is not Independent as to such matter) to have been subject to any relationship, arrangement or circumstance (including any relationship with a Major Participant) which, in the judgment of a majority of the board of directors (not including any director who is not Independent as to such matter), is reasonably possible or likely to interfere to an extent deemed unacceptable by such majority of the board (not including any director who is not Independent as to such matter) with his or her exercise of independent judgment as a director.

(l) “Institutional Investor” means any Person that is an entity or group identified in Rule 13d-1(b)(1)(ii) under the Exchange Act, provided that every filing made by such Person with the SEC under Regulation 13D-G (or any successor Regulation) under the Exchange Act with respect to such Person’s Beneficial Ownership of Capital Stock by such Person shall have contained a certification identical to the one required by Item 10 of Schedule 13G, or such other affirmation as shall be approved by the BCBSA and the Board of Directors.

(m) “Institutional Investor Ownership Limit” means that number of shares of Capital Stock one share lower than the number of shares of Capital Stock which would represent 10% of the Voting Power of all shares of Capital Stock issued and outstanding at the time of determination; provided that, that the Institutional Investor Ownership Limit may be revised from time to time pursuant to Section 14 of this Attachment A.

(n) “License Agreements” means the license agreements as constituted from time to time between the Corporation or any of its subsidiaries or affiliates and the BCBSA, including any and all addenda thereto, with respect to, among other things, the “Blue Cross” and “Blue Shield” names and marks.

(o) “Major Participant” means a Person who, except as provided in the next sentence, is (i) an Excess Owner, (ii) a Person that has filed proxy materials with the SEC (as defined in Section 1(w) of this Attachment A hereof) supporting a candidate for election to the Board of Directors of the Corporation in opposition to candidates approved by a majority of the board (not including any director who is not Independent as to such matter), (iii) a Person that has made a proposal, made a filing with the SEC or taken other actions in which such Person indicates that such Person may seek to become a Major Participant or which in the judgment of a majority of the board (not including any director who is not Independent as to such matter) indicates that it is reasonably possible or likely that such Person will seek to become a Major Participant, or (iv) such Person is an affiliate or associate of a Major Participant.
 

Notwithstanding the foregoing, in the event that a majority of the board (not including any director who is not Independent as to such matter) shall have approved an acquisition of outstanding Capital Stock of the Corporation, prior to the time such acquisition shall occur, which would otherwise render a Person a Major Participant and such Person (a) shall not have made any subsequent acquisition of outstanding Capital Stock of the Corporation not approved by a majority of the board (not including any director who is not Independent as to such matter) and (b) shall not have subsequently taken any of the actions specified in the preceding sentence without the prior approval of a majority of the board (not including any director who is not Independent as to such matter), then such Person shall not be deemed a Major Participant. In the event there shall be any question as to whether a particular Person is a Major Participant, the determination of a majority of the board (not including any director who is not Independent as to such matter)shall be binding upon all parties concerned.

(p) “Noninstitutional Investor” means any Person that is not an Institutional Investor.

(q) “Noninstitutional Investor Ownership Limit” means that number of shares of Capital Stock one share lower than the number of shares of Capital Stock which would represent 5% of the Voting Power of all shares of Capital Stock issued and outstanding at the time of determination; provided, however, that the Noninstitutional Investor Ownership Limit may be revised from time to time pursuant to Section 14 of this Attachment A.

(r) “Ownership Limit” means each of the General Ownership Limit, the Institutional Investor Ownership Limit and the Noninstitutional Investor Ownership Limit, as each may be revised from time to time pursuant to Section 14 of this Attachment A.

(s) “Permitted Transferee” means a Person whose acquisition of Capital Stock will not violate any Ownership Limit applicable to such Person.

(t) “Person” means any individual, firm, partnership, corporation, limited liability company, trust, association, joint venture or other entity, and shall include any successor (by merger or otherwise) or of any such entity.

(u) “Schedule 13D” means a report on Schedule 13D under Regulation 13D-G under the Exchange Act and any report which may be required in the future under any requirements which the BCBSA shall reasonably judge to have any of the purposes served by Schedule 13D.

(v) “Schedule 13G” means a report on Schedule 13G under Regulation 13D-G under the Exchange Act and any report which may be required in the future under any requirements which the BCBSA shall reasonably judge to have any of the purposes served by Schedule 13G.

(w) “SEC” means the United States Securities and Exchange Commission and any successor federal agency having similar powers.

(x) “Securities Act” means the Securities Act of 1933, as amended or supplemented, and any other federal law which the Board of Directors shall reasonably judge to have replaced or supplemented the coverage of the Securities Act.

(y) “Share Escrow Agent” means the Person appointed by the Corporation to act as escrow agent with respect to the Excess Shares.
 

(z) “Transfer” means any of the following which would affect the Beneficial Ownership of Capital Stock: (a) any direct or indirect sale, transfer, gift, hypothecation, pledge, assignment, devise or other disposition of Capital Stock (include ing (i) the granting of any option or entering into any agreement for the sale, transfer or other disposition of Capital Stock, or (ii) the sale, transfer, assignment or other disposition of any securities or rights convertible into or exchangeable for Capital Stock), whether voluntary or involuntary, whether of record, constructively or beneficially and whether by operation of law or otherwise, and (b) any other transaction or event, including, without limitation, a merger, consolidation, or acquisition of any Person, the expiration of a voting trust which is not renewed, or the aggregation of the Capital Stock Beneficially Owned by one Person with the Capital Stock Beneficially Owned by any other Person, which would affect the Beneficial Ownership of Capital Stock.

(aa) “Transferability” means the ability of a Person to Transfer shares of Capital Stock of the Corporation.

(bb) “Voting Power” means the voting power attributable to the shares of Capital Stock issued and outstanding at the time of determination and shall be equal to the number of all votes which could be cast in any election of any director, other than directors electable under the terms of any series of Preferred Stock in specified circumstances, which could be accounted for by all shares of Capital Stock issued and outstanding at the time of determination. If, in connection with an election for any particular position on the Board of Directors of the Corporation, shares in different classes or series are entitled to be voted together for purposes of such election, then in determining the number of “all votes which could be cast” in the election for that particular position for purposes of the preceding sentence, the number shall be equal to the number of votes which could be cast in the election for that particular position if all shares entitled to be voted in such election (regardless of series or class) were in fact voted in such election. For any particular Person, the Voting Power of such Person shall be equal to the quotient, expressed as a percentage, of the number of votes that may be cast with respect to shares of Capital Stock Beneficially Owned by such Person (including, for these purposes, any Excess Shares Beneficially Owned by such Person and held and/or voted by the Escrow Share Agent) divided by the total number of votes that could be cast by all stockholders of the Corporation (including such particular Person) based upon the issued and outstanding shares of Capital Stock at the time of determination. If the Corporation shall issue any series or class of shares for which positions on the Board of Directors of the Corporation are reserved or shall otherwise issue shares which have voting rights which can arise or vary based upon terms governing that class or series, then the percentage of the voting power represented by the shares of Capital Stock Beneficially Owned by any particular Person shall be the highest percentage of the total votes which could be accounted for by those shares in any election of any director.

SECTION 2.   (a) No Institutional Investor shall Beneficially Own shares of Capital Stock in excess of the Institutional Investor Ownership Limit. No Noninstitutional Investor shall Beneficially Own shares of Capital Stock in excess of the Noninstitutional Investor Ownership Limit. No Person shall Beneficially Own shares of Capital Stock in excess of the General Ownership Limit.

(b) The occurrence of any Transfer which would cause any Person to Beneficially Own Capital Stock in excess of any Ownership Limit applicable to such Person shall have the following legal consequences: (i) such Person shall receive no rights to the Excess Shares resulting from such Transfer (other than as specified in this Attachment A), and (ii) the Excess Shares resulting from such Transfer immediately shall be deemed to be conveyed to the Share Escrow Agent.

(c) Notwithstanding the foregoing, a Person’s Beneficial Ownership of Capital Stock shall not be deemed to exceed any Ownership Limit applicable to such Person if (A) the Excess Shares with respect to such Person do not exceed the lesser of 1% of the Voting Power of the Capital Stock or 1% of the ownership interest in the Corporation, and (B) within fifteen (15) days of the time when such Person becomes aware of the existence of such Excess Shares, such Person transfers or otherwise disposes of sufficient shares of Capital Stock so that such Person’s Beneficial Ownership of Capital Stock shall not exceed any Ownership Limit.
 

SECTION 3 . Any Excess Owner who acquires or attempts to acquire shares of Capital Stock in violation of Section 2 of this Attachment A , or any Excess Owner who is a transferee such that any shares of Capital Stock are deemed Excess Shares, shall immediately give written notice to the Corporation of such event and shall provide to the Corporation such other information as the Corporation may request.

SECTION 4 . The Corporation shall take such actions as it deems necessary to give effect to the transfer of Excess Shares to the Share Escrow Agent, including refusing to give effect to the Transfer or any subsequent Transfer of Excess Shares by the Excess Owner on the books of the Corporation. Excess Shares so held or deemed held by the Share Escrow Agent shall be issued and outstanding shares of Capital Stock. An Excess Owner shall have no rights in such Excess Shares except as expressly provided in this Attachment A and the administration of the Excess Shares escrow shall be governed by the terms of an Excess Share Escrow Agreement to be entered into between the Corporation and the Share Escrow Agent and having such terms as the Corporation shall deem appropriate.

SECTION 5 . The Share Escrow Agent, as record holder of Excess Shares, shall be entitled to receive all dividends and distributions as may be declared by the Board of Directors of the Corporation with respect to Excess Shares (the “Excess Share Dividends”) and shall hold the Excess Share Dividends until disbursed in accordance with the provisions of Section 9 of this Attachment A. In the event an Excess Owner receives any Excess Share Dividends (including, without limitation, Excess Share Dividends received prior to the time the Corporation determines that Excess Shares exist with respect to such Excess Owner) such Excess Owner shall repay such Excess Share Dividends to the Share Escrow Agent or the Corporation. The Corporation shall take all measures that it determines reasonably necessary to recover the amount of any Excess Share Dividends paid to an Excess Owner, including, if necessary, withholding any portion of future dividends or distributions payable on shares of Capital Stock Beneficially Owned by any Excess Owner (including future dividends on distributions on shares of Capital Stock which fall below the Ownership Limit as well as on Excess Shares), and, as soon as practicable following the Corporation’s receipt or withholding thereof, shall pay over to the Share Escrow Agent the dividends so received or withheld, as the case may be.

SECTION 6 . In the event of any voluntary or involuntary liquidation, dissolution, or winding up of, or any distribution of the assets of, the Corporation, the Share Escrow Agent shall be entitled to receive, ratably with each other holder of Capital Stock of the same class or series, that portion of the assets of the Corporation that shall be available for distribution to the holders of such class or series of Capital Stock. The Share Escrow Agent shall distribute the amounts received upon such liquidation, dissolution or winding up or distribution in accordance with the provisions of Section 9 of this Attachment A .

SECTION 7 . The Share Escrow Agent shall be entitled to vote all Excess Shares. The Share Escrow Agent shall vote, consent, or assent Excess Shares as follows:

(a) to vote in favor of each nominee to the Board of Directors of the Corporation whose nomination has been approved by a majority of the board (not including any director who is not Independent as to such matter) and to vote against any candidate for the Board of Directors of the Corporation for whom no competing candidate has been nominated or selected by a majority of the board (not including any director who is not Independent as to such matter);

(b) unless such action is initiated by or with the consent of the Board of Directors of the Corporation, (i) to vote against removal of any director of the Corporation, (ii) to vote against any alteration, amendment, change or addition to or repeal (collectively, “Change”) of the Bylaws or the Corporation’s Articles of Incorporation, (iii) not to nominate any candidate to fill any vacancy of the Board of Directors of the Corporation and (iv) not take any action by voting such Excess Shares that would be inconsistent with or would have the effect, directly or indirectly, of defeating or subverting the voting requirements contained in Section 7(a) of this Attachment A or this Section 7(b) of this Attachment A; and

(c) to the extent not covered by clauses (a) and (b) above, to vote as recommended by the Board of Directors of the Corporation.
 
SECTION 8 . (a) The Share Escrow Agent shall hold all Excess Shares until such time as they are sold in accordance with this Section 8 of Attachment A .
 

(b) The Share Escrow Agent shall sell or cause the sale of Excess Shares at such time or times and on such terms as shall be determined by the Corporation. The Share Escrow Agent shall have the right to take such actions as the Corporation shall deem appropriate to ensure that sales of Excess Shares shall be made only to Permitted Transferees.

(c) The Share Escrow Agent shall have the power to convey to the purchaser of any Excess Shares sold by the Share Escrow Agent ownership of such Excess Shares free of any interest of the Excess Owner of those Excess Shares and free of any other adverse interest arising through the Excess Owner. The Share Escrow Agent shall be authorized to execute any and all documents sufficient to transfer title to any Permitted Transferee.

(d) Upon acquisition by any Permitted Transferee of any Excess Shares sold by the Share Escrow Agent or the Excess Owner, such shares shall upon such sale cease to be Excess Shares and shall become regular shares of Capital Stock in the class or series to which such Excess Shares otherwise belong, and the purchaser of such shares shall acquire such shares free of any claims of the Share Escrow Agent or the Excess Owner.

(e) To the extent permitted by the GCLPR or other applicable law, neither the Corporation, the Share Escrow Agent nor anyone else shall have any liability to the Excess Owner or anyone else by reason of any action or inaction the Corporation or the Share Escrow Agent or any director, officer or agent of the Corporation shall take which any of them shall in good faith believe to be within the scope of their authority under this Attachment A or by reason of any decision as to when or how to sell any Excess Shares or by reason of any other action or inaction in connection with the activities permitted under this Attachment A which does not constitute gross negligence or willful misconduct.

Without limiting by implication the scope of the preceding sentence, to the extent permitted by law, neither the Share Escrow Agent nor the Corporation nor any director, officer or agent of the Corporation (a) shall have any liability on grounds that any of them failed to take actions which would or could have produced higher proceeds for any of the Excess Shares or by reason of the manner or timing for any disposition of any Excess Shares, and (b) shall be deemed to be a fiduciary or agent of any Excess Owner.

SECTION 9 . The proceeds from the sale of the Excess Shares and any Excess Share Dividends shall be distributed as follows (i) first, to the Share Escrow Agent for any costs and expenses incurred in respect of its administration of the Excess Shares that have not theretofore been reimbursed by the Corporation; (ii) second, to the Corporation for all costs and expenses incurred by the Corporation in connection with the appointment of the Share Escrow Agent, the payment of fees to the Share Escrow Agent with respect to the services provided by the Share Escrow Agent in respect of the escrow and for any other direct or indirect and out of pocket expenses incurred by the Corporation in connection with the Excess Shares, including any litigation costs and expenses, and all funds expended by the Corporation to reimburse the Share Escrow Agent for costs and expenses incurred by the Share Escrow Agent in respect of its administration of the Excess Shares and for all fees, disbursements and expenses incurred by the Share Escrow Agent in connection with the sale of the Excess Shares; and (iii) third, the remainder thereof (as the case may be) to the Excess Owner; provided, however, if the Corporation shall have any questions as to whether any security interest or other interest adverse to the Excess Owner shall have existed with respect to any Excess Shares, neither the Share Escrow Agent, the Corporation nor anyone else shall have the obligation to disburse proceeds for those shares until the Share Escrow Agent shall be provided with such evidence as the Corporation shall deem necessary to determine the parties who shall be entitled to such proceeds.
 

SECTION 10 . Each certificate for Capital Stock shall bear the following legend:
 
“The shares of stock represented by this certificate are subject to restrictions on ownership and Transfer. All capitalized terms in this legend have the meanings ascribed to them in the Corporation’s Articles of Incorporation, as the same may be amended from time to time, a copy of which, including the restrictions on ownership and Transfer, shall be sent without charge to each stockholder who so requests. No Person shall Beneficially Own shares of Capital Stock in excess of any Ownership Limit applicable to such Person. Subject to certain limited specific exemptions, (i) Beneficial Ownership of that number of shares of Capital Stock by an Institutional Investor which would represent 10% or more of the Voting Power would exceed the Institutional Investor Ownership Limit, (ii) Beneficial Ownership of that number of shares of Capital Stock by a Noninstitutional Investor which would represent 5% or more of the Voting Power would exceed the Noninstitutional Investor Ownership Limit, and (iii) Beneficial Ownership of (a) 20% or more of the issued and outstanding shares of Common Stock or (b) any combination of shares in any series or class of Capital Stock that represents 20% or more of the Ownership Interest in the Corporation (determined as provided in the Corporation’s Articles of Incorporation) would exceed the General Ownership Limit. Any Person who attempts to Beneficially Own shares of Capital Stock in violation of this limitation must immediately notify the Corporation. Upon the occurrence of any event that would cause any person to exceed any Ownership Limit applicable to such Person, all shares of Capital Stock Beneficially Owned by such Person in excess of any Ownership Limit applicable to such Person shall automatically be deemed Excess Shares and shall be transferred automatically to the Share Escrow Agent and shall be subject to the provisions of the Corporation’s Articles of Incorporation. The foregoing summary of the restrictions on ownership and Transfer is qualified in its entirety by reference to the Corporation’s Articles of Incorporation.”

The legend may be amended from time to time to reflect amendments to the Corporation’s Articles of Incorporation, or revisions to the Ownership Limits in accordance with Section 14 of this Attachment A.

SECTION 11 . Nothing contained in this Attachment A or in any other provision of the Corporation’s Articles of Incorporation shall limit the authority of the Corporation to take such other action as it deems necessary or advisable to protect the Corporation and the interests of its stockholders.

SECTION 12 . Nothing contained in the Corporation’s Articles of Incorporation (including this Attachment A) shall preclude the settlement of any transactions entered into through the facilities of the New York Stock Exchange, Inc. or any other exchange or through the means of any automated quotation system now or hereafter in effect.

SECTION 13 . Except in the case of manifest error, any interpretation of this Attachment A by the Board of Directors of the Corporation shall be conclusive and binding; provided, however, that in making any such interpretation, the Board of Directors of the Corporation shall consider, wherever relevant, the Corporation’s obligations to the BCBSA.

SECTION 14 . A majority of the board of directors shall have the right to revise the definition of one or more Ownership Limits to change the percentage ownership of Capital Stock under such Ownership Limit to conform the definition to a change to the terms of the License Agreements or as required or permitted by the BCBSA. In the event the Corporation issues any series or class of Capital Stock other than Common Stock, then majority of the board of directors shall have the power to determine the manner in which each class or series of Capital Stock shall be counted for purposes of determining each Ownership Limit. Any such revision to the definition of any Ownership Limit shall not be deemed a Change to the Corporation’s Articles of Incorporation (including this Attachment A), and shall not require stockholder approval under Article THIRTEENTH of the Corporation’s Articles of Incorporation; provided, however, that no such revision shall be effective until such time as the Corporation shall have notified the stockholders of such revision in such manner as it shall deem appropriate under the circumstances (provided that notification of any such revision by means of a filing by the Corporation describing such revision with the SEC under the Exchange Act or with the Secretary of State of the Commonwealth of Puerto Rico under the GCLPR shall be deemed appropriate notice under all circumstances).
 

ATTACHMENT B TO AMENDED AND RESTATED
ARTICLES OF INCORPORATION
OF TRIPLE-S MANAGEMENT CORPORATION

CONVERSION RIGHTS

Class A Common Stock

1.               Certain Definitions. As used in this Attachment B , the following terms shall have the following meanings, unless the context otherwise requires:

Board of Directors ” means either the board of directors of the Corporation or any duly authorized committee of such board.
 
Business Day ” means any day other than a Saturday, Sunday or a day in which banks in San Juan, Puerto Rico or New York, New York are permitted or required to be closed.
 
Corporation ” shall mean Triple-S Management Corporation, and shall include any successor to such Corporation.
 
IPO ” means the initial public offering of the Corporation’s Class B Common Stock.
 
non-medical heir ” refers to a former shareholders’ heir who was not a physician or dentist at the time of the death of the former shareholder.
 
Officer ” means the President or any Vice President of the Corporation.
 
outstanding ” means, when used with respect to Class A Common Stock, as of any date of determination, all shares of Class A Common Stock outstanding as of such date; provided , however, that, in determining whether the holders of Class A Common Stock have given any request, demand, authorization, direction, notice, consent or waiver or taken any other action hereunder, Class A Common Stock owned by the Corporation shall be deemed not to be outstanding, except that, in determining whether the Registrar shall be protected in relying upon any such request, demand, authorization, direction, notice, consent, waiver or other action, only Class A Common Stock which the Registrar has actual knowledge of being so owned shall be deemed not to be outstanding.
 
Person ” means an individual, a corporation, a partnership, a limited liability company, an association, a trust or any other entity or organization, including a government or political subdivision or an agency or instrumentality thereof.
 
Record Date ” means, with respect to any dividend, distribution or other transaction or event in which the holders of Class A Common Stock have the right to receive any cash, securities or other property or in which the Class A Common Stock (or other applicable security) is exchanged for or converted into any combination of cash, securities or other property, the date fixed for determination of stockholders entitled to receive such cash, securities or other property (whether such date is fixed by the Board of Directors or by statute, contract or otherwise).
 
Registrar ” shall mean the registrar for the Corporation’s capital stock, as may be duly designated by resolution of the Board of Directors.
 
share acquisition agreement ” means any agreement executed by SSS and a health care provider under which SSS agreed to sell, and the provider agreed to buy, shares of SSS, in each case subject to certain conditions.
 

SSS ” means the predecessor entity of TSI, Seguros de Servicios de Salud de Puerto Rico, Inc.
 
Subsidiary ” means, with respect to any Person, (a) any corporation, association or other business entity of which more than 50% of the total voting power of shares of capital stock entitled (without regard to the occurrence of any contingency) to vote in the election of directors, managers or trustees thereof is at the time owned or controlled, directly or indirectly, by such Person or one or more of the other Subsidiaries of that Person (or a combination thereof) and (b) any partnership (i) the sole general partner or the managing general partner of which is such Person or a Subsidiary of such Person or (ii) the only general partners of which are such Person or one or more Subsidiaries of such Person (or any combination thereof).
 
Trading Day ” means a day during which trading in securities generally occurs on the New York Stock Exchange or, if the Class B Common Stock is not listed on the New York Stock Exchange, on the principal other national or regional securities exchange on which the Class B Common Stock is then listed or, if the Class B Common Stock is not listed on a national or regional securities exchange, on the principal other market on which the Class B Common Stock is then traded.
 
Transfer Agent ” shall mean the transfer agent for the Corporation’s capital stock, as may be duly designated by resolution of the Board of Directors.
 
TSI ” means Triple-S, Inc., a wholly-owned subsidiary of the Corporation, and it successors.
 
2.              Conversion. Each share of Class A Common Stock shall be converted in accordance with, and subject to, this Attachment B into one fully paid and non-assessable share of Class B Common Stock (as such shares shall then be constituted) on the date notice of conversion is given. The Class A Common Stock shall be convertible only upon the satisfaction of the conditions specified in clauses (i) through (iv) below. The Class B Common Stock shall not carry any conversion rights or otherwise be convertible into Class A Common Stock.

(i)              Conversion in the Initial Public Offering. Shares of Class A Common Stock sold to the underwriters in the IPO shall be converted into shares of Class B Common Stock upon the closing of such sale.

(ii)             Conversion Following the First Anniversary of the IPO. At any time starting on the date that is 12 months from the completion of the IPO, a portion of the Class A Common Stock may be converted into shares of Class B Common Stock, if the Board of Directors has approved a resolution authorizing such conversion and all other conditions imposed by such resolution have been satisfied. Such conditions could include a condition that, prior to conversion, the shares be sold to the public in an underwritten offering. The aggregate number of shares of Class A Common Stock that may be so converted, together with all shares of Class A common stock that shall have been converted on any prior occasion, shall be limited to two-thirds of the number of shares of common stock outstanding immediately prior to the consummation of the IPO.

(iii)            Conversion Following the Fifth Anniversary of the IPO . At any time starting five years after the completion of the IPO, any remaining Class A Common Stock may be converted into shares of Class B Common Stock, if the Board of Directors has approved a resolution authorizing the conversion and all other conditions imposed by such resolution have been satisfied.

(iv)            Conversion Upon Resolution of Potential Claims. Notwithstanding the provisions of Section 2(iii), beginning one year after completion of the IPO, all or any portion of Class A Common Stock may be converted into shares of Class B Common Stock on or after the date on which the Board of Directors shall have approved a resolution in which it determines that any and all potential claims against the Corporation under any share acquisition agreement or by any purported non-medical heir in respect of the inheritance of shares of common stock have been resolved; provided, that such conversion shall be subject to the satisfaction of all conditions imposed by the Board of Directors.
 

3.              Capital Stock Issuable Upon Conversion. Capital stock issuable by the Corporation upon conversion of the Class A Common Stock shall include only shares of the class designated as Class B Common Stock of the Corporation or shares of any class or classes resulting from any reclassification or reclassifications thereof and that have no preference in respect of dividends or of amounts payable in the event of any voluntary or involuntary liquidation, dissolution or winding up of the Corporation and which are not subject to redemption by the Corporation.

ANTI-DILUTION RIGHTS

Class B Common Stock
1. Definitions. As used in this Attachment C , capitalized terms not otherwise defined herein shall have the meaning assigned to such term in the Amended and Restated Articles of Incorporation and Attachment B . The following terms have the following meanings, unless the context otherwise requires:

Claimant Share ” shall have the meaning set forth in Section 2(b) below.
 
“Closing Sale Price” means, with respect to shares of Class B Common Stock on any Trading Day, the closing sale price per share (or, if no closing sale price is reported, the average of the closing bid and ask prices or, if more than one in either case, the average of the average closing bid and the average closing ask prices) on such date as reported on the principal United States securities exchange on which shares of Class B Common Stock are traded or on the principal other national or regional securities exchange on which the Class B Common Stock is then listed. In the absence of such listing, the Board of Directors shall be entitled to determine the Closing Sale Price on the basis it considers appropriate. The Closing Sale Price shall be determined without reference to extended or after hours trading.
 
Pre-TSI Issuance Class B Common Stock ” shall have the meaning set forth in Section 3(a) below.
 
TSI Claimant Shares ” shall have the meaning set forth in Section 3(b) below.
 
2. Issuance of the Corporation’s Common Stock .

a.               General . Upon the occurrence of a triggering event described in Section 2(b) below, each holder of Class B Common Stock at the close of business on the Trading Day immediately prior to the issuance date of a Claimant Share (“original Class B Common Stock”) shall be entitled to receive as a distribution from the Corporation such number of newly-issued or treasury fully-paid and non-assessable shares of Class B Common Stock (as such shares shall then be constituted) as is determined by the formula set forth in Section 2(c).

b.              Triggering Event . Holders of Class B Common Stock shall be entitled to the anti-dilution rights set forth in this Section 2 upon the issuance of any share of Common Stock (a “Claimant Share”) for a purchase price of less than the Closing Sales Price of the Class B Common Stock on the Trading Day next preceding the first public announcement by the Corporation that such Claimant Share would be issued,

i.
in respect of a claim against the Corporation under any share acquisition agreement; or

ii.
to any purported non-medical heir of a former shareholder of the Corporation or any of its predecessor entities or any of the predecessor entities of TSI which holder’s shares of common stock or common stock of any of the Corporation’s predecessor entities or the predecessor entities of TSI were cancelled following the holder’s death in respect of any purported right of such heir to receive, by way of testate or intestate transfer or otherwise, the shares of common stock or such common stock owned by such shareholder at the time of his or her death.
 

c.               Anti-Dilution Formula . The number of newly issued or treasury fully-paid and non-assessable shares of Class B Common Stock issued in respect of each share of Class B Common Stock outstanding immediately prior to the applicable issuance of Claimant Shares shall be determined according to the following formula:
 
 
DR
=
(CAO + X)
 
 
(CAO + Y)
 
 
Where:

DR = the number of shares of Class B Common Stock that a holder of one share of original Class B Common Stock would be entitled to hold following the issuance of one or more Claimant Shares;

CAO = the number of shares of Class A Common Stock outstanding immediately prior to the date on which such Claimant Shares are issued;

X = the aggregate number of such Claimant Shares issued; and

Y = the number of shares of Common Stock equal to the quotient of (A) the aggregate consideration paid for such Claimant Shares and (b) the average of the Closing Sale Prices of Class B Common Stock for the 10 consecutive Trading Days ending on the Business Day immediately preceding the date on which the planned issuance of the Claimant Shares was first publicly announced by the Corporation.

For purposes of this Section 2, the Board of Directors shall determine, in its sole discretion, all matters of fact relevant to the application of the rights set forth in this Section 2, including, but not limited to, (i) the date of the first public announcement by the Corporation of any issuance of a Claimant Share, (ii) whether any Claimant Share was issued for less than the applicable Closing Sales Price of Class B Common Stock, and (iii) the value of the consideration paid, if other than cash, in respect of Claimant Shares issued.

3.               Issuance of TSI Common Stock .

a.               General . Upon the occurrence of a triggering event described in Section 3(b) below, each holder of Class B Common Stock at the close of business on the Trading Day immediately prior to the issuance of a TSI Claimant Share (“Pre-TSI Issuance Class B Common Stock”) shall be entitled to receive as a distribution from the Corporation such number of newly-issued or treasury fully-paid and non-assessable shares of Class B Common Stock (as such shares shall then be constituted) as is determined by application of the formula set forth in Section 3(c).

b.              Triggering Event . Holders of Class B Common Stock shall be entitled to the rights set forth in this Section 3 upon the issuance of any share of common stock of TSI for a purchase price of less than the fair value of such share in respect of a claim under any share acquisition agreement (a “TSI Claimant Share”).

c.               TSI Anti - Dilution Formula . The number of newly issued or treasury fully paid and non-assessable shares of Class B Common Stock issued in respect of each share of Pre-TSI Issuance Class B Common Stock shall be determined according to the following formula:

 
X
=
OA (MC – VA)
 
 
OB (VA – VO)
 

Where:
 
X = the number of shares of Class B Common Stock a holder of one share of Pre-TSI Issuance Class B Common Stock would be entitled to hold following the issuance of one or more TSI Claimant Shares;
 
OA = the number of shares of Class A Common Stock outstanding immediately prior to such issuance;
 
OB = the number of shares of Class B Common Stock outstanding immediately prior to such issuance;
 

MC = the market capitalization of the Corporation immediately prior to the first public announcement of such issuance, calculated as the Closing Sale Price per share of Class B Common Stock on the Trading Day next preceding such announcement, multiplied by the total number of shares of Class B Common Stock and Class A Common Stock outstanding on that day;
 
VA = MC multiplied by the percentage of the Corporation’s common share capital represented by the Class A Common Stock; and
 
VO = the difference between the fair value of the TSI Claimant Shares issued and the total consideration paid for such TSI Claimant Shares.
 
Provided, that in any case in which VA – VO is less than $0.01, VA – VO shall be deemed to be $0.01.
 
For purposes of this Section 3, the Board of Directors shall determine, in its sole discretion, all matters of fact relevant to the application of the rights set forth in this Section 3, including, but not limited to, (i) each of the values in the foregoing formula, (ii) whether a TSI Claimant Share was issued for less than fair value and (iii) the value of the consideration paid, if other than cash, in respect of TSI Claimant Shares issued.
 
4.               Issuance of Shares .

a.               Issuance of Shares of Class B Common Stock . Capital stock issuable by the Corporation upon the occurrence of a triggering event set forth in Section 2(b) or 3(b) above shall include only shares of the class designated as Class B Common Stock of the Corporation or shares of any class or classes resulting from any reclassification or reclassifications thereof and that have no preference in respect of dividends or of amounts payable in the event of any voluntary or involuntary liquidation, dissolution or winding up of the Corporation and which are not subject to redemption by the Corporation.

b.              Settlement of Fractional Shares. Any fractional shares of Class B Common Stock resulting from any issuance of shares pursuant to the anti-dilution rights set forth in this Attachment C shall be aggregated with all other fractional shares resulting from the issuance of shares pursuant to such rights on the same day and sold on the open market by the transfer agent for the Class B Common Stock or such other agent as may be designated by the Board of Directors in its sole discretion. The proceeds of such sale will be distributed to the registered holders of Class B Common Stock to whom such fractional shares would have been issued, in proportion to such holders’ entitlement to such fractional shares.

5. Limitation of Anti-Dilution Rights . Except as otherwise set forth in this Attachment C, the Class B Common Stock shall not be entitled to anti-dilution rights with respect to the issuance of any shares of capital stock of the Corporation, including, but not limited to, shares of capital stock issued in connection with any current or future equity compensation plan.

6. Termination of Anti-Dilution Rights . The anti-dilution rights granted to holders of Class B Common Stock described in this Attachment C shall terminate upon the conversion of all Class A Common Stock to Class B Common Stock.
 
 


Exhibit 31.1
 
CERTIFICATION

I, Roberto García-Rodríguez, 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)) and internal control over financial reporting (as defined in Exchange Act Rules 13a-15(f) and 15d-15(f)) 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.
Designed such internal control over financial reporting, or caused such internal control over financial reporting to be designed under our supervision, to provide reasonable assurance regarding the reliability of financial reporting and the preparation of financial statements for external purposes in accordance with generally accepted accounting principles;
c.
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
d.
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 control over financial reporting.

Date:
May 9, 2017
 
By:
/s/ Roberto García-Rodríguez
 
       
Roberto García-Rodríguez
 
       
President and Chief Executive Officer
 
 
 

 

Exhibit 31.2
 
CERTIFICATION

I, Juan J. Román-Jiménez, 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)) and internal control over financial reporting (as defined in Exchange Act Rules 13a-15(f) and 15d-15(f)) 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)
Designed such internal control over financial reporting, or caused such internal control over financial reporting to be designed under our supervision, to provide reasonable assurance regarding the reliability of financial reporting and the preparation of financial statements for external purposes in accordance with generally accepted accounting principles;
c)
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
d)
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 control over financial reporting.

Date:
May 9, 2017
 
By:
/s/ Juan J. Román-Jiménez
 
       
Juan J. Román-Jiménez
 
       
Executive Vice President and Chief Financial Officer
 
 
 


Exhibit 32.1
 
CERTIFICATION
 
PURSUANT TO 18 U.S.C. SECTION 1350,
AS ADOPTED PURSUANT TO
SECTION 906 OF THE SARBANES-OXLEY ACT OF 2002

In connection with the Quarterly Report of Triple-S Management Corporation (the Company) on Form 10-Q for the period ended March 31, 2017 as filed with the Securities and Exchange Commission on the date hereof (the Report), I, Roberto García-Rodríguez , President and Chief Executive Officer of the Company, certify, pursuant to 18 U.S.C. § 1350, as adopted pursuant to § 906 of the Sarbanes-Oxley Act of 2002, that:
 
a)
The Report fully complies with the requirements of section 13(a) or 15(d) of the Securities Exchange Act of 1934; and
 
b)
The information contained in the Report fairly presents, in all material respects, the financial condition and results of operations of the Company.

Date:
May 9, 2017
 
By:
/s/ Roberto García-Rodríguez
 
       
Roberto García-Rodríguez
 
       
President and Chief Executive Officer
 

A signed original of this written statement required by Section 906 has been provided to the Corporation and will be retained by the Corporation and furnished to the Securities and Exchange Commission or its staff upon request.
 
 

 

Exhibit 32.2
 
CERTIFICATION
 
PURSUANT TO 18 U.S.C. SECTION 1350,
AS ADOPTED PURSUANT TO
SECTION 906 OF THE SARBANES-OXLEY ACT OF 2002

In connection with the Quarterly Report of Triple-S Management Corporation (the Company) on Form 10-Q for the period ended March 31, 2017 as filed with the Securities and Exchange Commission on the date hereof (the Report), I, Juan J. Román-Jiménez, Executive Vice President and Chief Financial Officer of the Company, certify, pursuant to 18 U.S.C. § 1350, as adopted pursuant to § 906 of the Sarbanes-Oxley Act of 2002, that:
 
a)
The Report fully complies with the requirements of section 13(a) or 15(d) of the Securities Exchange Act of 1934; and
 
b)
The information contained in the Report fairly presents, in all material respects, the financial condition and results of operations of the Company.

Date:
May 9, 2017
 
By:
/s/ Juan J. Román-Jiménez
 
       
Juan J. Román-Jiménez
 
       
Executive Vice President and Chief Financial Officer
 

A signed original of this written statement required by Section 906 has been provided to the Corporation and will be retained by the Corporation and furnished to the Securities and Exchange Commission or its staff upon request.