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

FORM 10-Q
 (Mark(Mark One)

QUARTERLY REPORT PURSUANT TO SECTION 13 OR 15(D) OF THE SECURITIES EXCHANGE ACT OF 1934

For the quarterly period ended September 30, 2016March 31, 2017

orOr

TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(D) OF THE SECURITIES EXCHANGE ACT OF 1934

For the transition period from  to______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)
 
(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'sissuer’s classes of common stock, as of the latest practicable date.
 
Title of each class
Outstanding at September 30, 2016March 31, 2017
Common Stock Class A, $1.00 par value950,968
Common Stock Class B, $1.00 par value23,321,74823,491,670
 


Triple-S Management Corporation
FORM 10-Q
For the Quarter Ended September 30, 2016March 31, 2017
 
Table of Contents
 
3
  
 Item 1.3
    
 Item 2.30
    
 30
 30
 31
 32
 3332
 33
 3635
 3937
�� 4038
 4139
   
 Item 3.41
Item 4.Controls and Procedures41
41
Item 1.Legal Proceedings41
Item 1A.Risk Factors41
Item 2.Unregistered Sales of Equity Securities and Use of Proceeds42
Item 3.Defaults Upon Senior Securities42
    
 Item 4.43
43
Item 1.43
Item 1A.43
Item 2.44
Item 3.44
Item 4.4442
    
 Item 5.4442
    
 Item 6.4442
    
4543
 
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)

 
September 30,
2016
  
December 31,
2015
  
March 31,
2017
  
December 31,
2016
 
Assets            
Investments and cash:            
Securities available for sale, at fair value:            
Fixed maturities $1,162,209  $1,133,645  $1,153,545  $1,151,643 
Equity securities  302,077   197,071   277,149   270,349 
Securities held to maturity, at amortized cost:                
Fixed maturities  2,833   2,929   2,514   2,836 
Policy loans  8,372   7,901   8,546   8,564 
Cash and cash equivalents  165,523   197,818   218,884   103,428 
Total investments and cash  1,641,014   1,539,364   1,660,638   1,536,820 
Premiums and other receivables, net  333,964   282,646   292,837   286,365 
Deferred policy acquisition costs and value of business acquired  190,443   190,648   195,513   194,787 
Property and equipment, net  68,184   73,953   66,756   66,369 
Deferred tax asset  57,950   52,361   64,128   57,768 
Goodwill  25,397   25,397   25,397   25,397 
Other assets  57,966   41,776   53,186   51,493 
Total assets $2,374,918  $2,206,145  $2,358,455  $2,218,999 
Liabilities and Equity        
Liabilities and Stockholders’ Equity        
Claim liabilities $511,377  $491,765  $530,304  $487,943 
Liability for future policy benefits  315,404   289,530   326,162   321,232 
Unearned premiums  160,066   80,260   163,780   79,310 
Policyholder deposits  181,323   179,287   179,599   179,382 
Liability to Federal Employees' Health Benefits Program (FEHBP)  34,474   26,695 
Liability to Federal Employees’ Health Benefits and Federal Employees’ Programs  37,206   34,370 
Accounts payable and accrued liabilities  188,517   176,910   171,643   169,449 
Deferred tax liability  23,938   15,070   19,599   18,850 
Long-term borrowings  35,597   36,827   34,465   35,085 
Liability for pension benefits  56,015   62,945   30,472   30,892 
Total liabilities  1,506,711   1,359,289   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 September 30, 2016 and December 31, 2015, respectively
  951   951 
Common stock Class B, $1 par value. Authorized 100,000,000 shares; issued and outstanding 23,321,748 and 24,047,755 shares at September 30, 2016 and December 31, 2015, respectively
  23,322   24,048 
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  65,058   83,438   63,978   65,592 
Retained earnings  718,861   713,466   726,562   730,904 
Accumulated other comprehensive income  60,691   25,623   50,920   42,395 
Total Triple-S Management Corporation stockholders' equity  868,883   847,526 
Total Triple-S Management Corporation stockholders’ equity  865,903   863,163 
Non-controlling interest in consolidated subsidiary  (676)  (670)  (678)  (677)
Total stockholders' equity  868,207   846,856 
Total liabilities and equity $2,374,918  $2,206,145 
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.
 
3

Triple-S Management Corporation
Condensed Consolidated Statements of Earnings (Unaudited)
(dollar amounts in thousands, except per share data)

 
Three months ended
September 30,
  
Nine months ended
September 30,
  
Three months ended
March 31,
 
 2016  2015  2016  2015  2017  2016 
Revenues:                  
Premiums earned, net $721,187  $746,718  $2,188,770  $2,033,383  $702,273  $738,534 
Administrative service fees  4,146   6,163   13,749   39,835   4,379   5,083 
Net investment income  12,337   10,618   36,570   32,534   12,016   11,358 
Other operating revenues  871   862   2,598   2,656   965   812 
Total operating revenues  738,541   764,361   2,241,687   2,108,408   719,633   755,787 
Net realized investment gains (losses):                
Total other-than-temporary impairment losses on securities  -   (1,627)  (1,434)  (4,489)
Net realized gains, excluding other-than-temporary impairment losses on securities  5,376   66   8,388   19,748 
Total net realized investment gains (losses) on sale of securities  5,376   (1,561)  6,954   15,259 
Net realized investment gains on sale of securities  336   58 
Other income, net  734   2,289   5,468   5,131   2,525   875 
Total revenues  744,651   765,089   2,254,109   2,128,798   722,494   756,720 
Benefits and expenses:                        
Claims incurred  629,169   634,909   1,877,950   1,705,237   620,863   626,694 
Operating expenses  123,406   125,887   367,498   380,086   110,946   122,980 
Total operating costs  752,575   760,796   2,245,448   2,085,323   731,809   749,674 
Interest expense  1,893   1,979   5,729   6,235   1,686   1,882 
Total benefits and expenses  754,468   762,775   2,251,177   2,091,558   733,495   751,556 
(Loss) income before taxes  (9,817)  2,314   2,932   37,240   (11,001)  5,164 
Income tax benefit  (7,873)  (1,850)  (2,457)  (631)
Income taxes  (6,658)  1,709 
Net (loss) income  (1,944)  4,164   5,389   37,871   (4,343)  3,455 
Less: Net loss attributable to non-controlling interest  3   30   6   85   1   1 
Net (loss) income attributable to Triple-S Management Corporation $(1,941) $4,194  $5,395  $37,956  $(4,342) $3,456 
Earnings per share attributable to Triple-S Management Corporation                        
Basic net (loss) income per share $(0.08) $0.17  $0.22  $1.46  $(0.18) $0.14 
Diluted net (loss) income per share $(0.08) $0.16  $0.22  $1.46  $(0.18) $0.14 

See accompanying notes to unaudited condensed consolidated financial statements.
 
4

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 
  
Three months ended
September 30,
  
Nine months ended
September 30,
 
  2016  2015  2016  2015 
Net (loss) income $(1,944) $4,164  $5,389  $37,871 
Other comprehensive income (loss), net of tax:                
Net unrealized change in fair value of available for sale securities, net of taxes  (1,884)  (4,821)  33,523   (32,071)
Defined benefit pension plan:                
Actuarial loss, net  525   1,016   1,754   2,919 
Prior service credit, net  (59)  (77)  (209)  (215)
Total other comprehensive (loss) income, net of tax  (1,418)  (3,882)  35,068   (29,367)
Comprehensive (loss) income  (3,362)  282   40,457   8,504 
Comprehensive loss attributable to non-controlling interest  3   30   6   85 
Comprehensive (loss) income attributable to Triple-S Management Corporation $(3,359) $312  $40,463  $8,589 

See accompanying notes to unaudited condensed consolidated financial statements.
 
5

Triple-S Management Corporation
Condensed Consolidated Statements of Stockholders’ Equity (Unaudited)
(dollar amounts in thousands)

 2016  2015  2017  2016 
Balance at January 1 $847,526  $858,558  $863,163  $847,526 
Share-based compensation  2,266   5,520   (1,443)  1,421 
Stock issued upon the exercise of stock options  55   179 
Repurchase and retirement of common stock  (21,427)  (41,165)  -   (8,027)
Comprehensive income  40,463   8,589   4,183   23,667 
Total Triple-S Management Corporation stockholders' equity  868,883   831,681 
Total Triple-S Management Corporation stockholders’ equity  865,903   864,587 
Non-controlling interest in consolidated subsidiary  (676)  (617)  (678)  (671)
Balance at September 30 $868,207  $831,064 
Balance at March 31 $865,225  $863,916 

See accompanying notes to unaudited condensed consolidated financial statements.
 
6

Triple-S Management Corporation
Condensed Consolidated Statements of Cash Flows (Unaudited)
(dollarDollar amounts in thousands)

  
Nine months ended
September 30,
 
  2016  2015 
Cash flows from operating activities:      
Net income $5,389  $37,871 
Adjustments to reconcile net income to net cash provided by operating activities:        
Depreciation and amortization  10,617   12,031 
Net amortization of investments  6,181   4,956 
Additions to the allowance for doubtful receivables  2,498   11,425 
Deferred tax benefit  (4,026)  (5,140)
Net realized investment gain on sale of securities  (6,954)  (15,259)
Interest credited to policyholder deposits  3,091   2,557 
Share-based compensation  1,931   5,520 
(Increase) decrease in assets:        
Premium and other receivables, net  (53,816)  10,983 
Deferred policy acquisition costs and value of business acquired  (5,250)  (2,928)
Deferred taxes  (2,384)  869 
Other assets  (15,598)  (13,602)
Increase (decrease) in liabilities:        
Claim liabilities  19,612   82,895 
Liability for future policy benefits  25,874   17,410 
Unearned premiums  79,806   (4,216)
Liability to FEHBP  7,779   8,032 
Accounts payable and accrued liabilities  8,261   18,066 
Net cash provided by operating activities  83,011   171,470 
 (Continued)
  
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)        
 
7

Triple-S Management Corporation
Condensed Consolidated Statements of Cash Flows (Unaudited)
(dollarDollar amounts in thousands)


 
Nine months ended
September 30,
  
Three months ended
March 31,
 
 2016  2015  2017  2016 
Cash flows from investing activities:            
Proceeds from investments sold or matured:            
Securities available for sale:            
Fixed maturities sold $227,631  $307,545  $26,023  $90,328 
Fixed maturities matured/called  32,308   38,323   5,001   699 
Equity securities sold  67,054   81,176   10,272   11,257 
Securities held to maturity - fixed maturities matured/called  1,220   639 
Securities held to maturity:        
Fixed maturities matured/called  703   - 
Acquisition of investments:                
Securities available for sale:                
Fixed maturities  (258,378)  (360,588)  (33,738)  (118,039)
Equity securities  (153,399)  (81,901)  (5,482)  (92,956)
Securities held to maturity - fixed maturities  (1,124)  (623)
Securities held to maturity:        
Fixed maturities  (382)  - 
Increase in other investments  (1,939)  (2,139)  (2,044)  (182)
Net disbursements for policy loans  (471)  (498)
Net change in policy loans  18   (231)
Net capital expenditures  (3,517)  (5,628)  (3,295)  (1,465)
Net cash used in investing activities  (90,615)  (23,694)  (2,924)  (110,589)
Cash flows from financing activities:                
Change in outstanding checks in excess of bank balances  (1,035)  (5,262)  (11,401)  1,916 
Repayments of long-term borrowings  (1,230)  (12,230)  (24,676)  (410)
Proceeds from long-term borrowings  24,266   - 
Repurchase and retirement of common stock  (21,371)  (40,983)  -   (8,027)
Proceeds from policyholder deposits  12,488   5,587   4,116   3,403 
Surrenders of policyholder deposits  (13,543)  (10,468)  (4,890)  (2,905)
Net cash used in financing activities  (24,691)  (63,356)  (12,585)  (6,023)
Net (decrease) increase in cash and cash equivalents  (32,295)  84,420 
Net increase (decrease) in cash and cash equivalents  115,456   (85,352)
Cash and cash equivalents:                
Beginning of period  197,818   110,037   103,428   197,818 
End of period $165,523  $194,457  $218,884  $112,466 

See accompanying notes to unaudited condensed consolidated financial statements.
 
8

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, 2015.2016.

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 and nine months ended September 30, 2016March 31, 2017 are not necessarily indicative of the results for the full year ending December 31, 2016.2017.

(2)Recent Accounting Standards

On January 5, 2016, March 10, 2017, the Financial Accounting Standards Board (FASB)FASB issued guidance to enhanceimprove the reporting model for financial instruments to provide userspresentation of financial statements with more decision-useful information.  Amongdefined benefit costs in the many targeted improvements to U.S. GAAPincome 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 (1) requiring equity investments, except those accounted for under the equity method of accounting or those that result in consolidation of the investee,required to be measured at fair value with changespresented in fair value recognized in net income; (2) simplifying the impairment assessmentincome statement separately from the service cost component and outside a subtotal of equity investments without readily determinable fair values by requiringincome 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 qualitative assessment to identify impairment; (3) eliminating the requirement to disclose the fair valuecost of financial instruments measured at amortized cost for entities that are not public business entities; and (4) clarifying that an entity should evaluate the need forinternally manufactured inventory or a valuation allowance on a deferred tax asset related to available-for-sale securities in combination with the entity’s other deferred tax assets.  This guidance applies to all entities that hold financial assets or owe financial liabilities. 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.  We are currently evaluating the impact thatSince, we do not present a subtotal of income from operations, the adoption of this guidance mayshould not have a material impact on the Company'spresentation of the Company’s consolidated financial statements.result of operations.

On February 25, 2016, January 26, 2017, the FASB issued guidance to increase transparencysimplify 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 comparability among organizations by recognizing lease assets and lease liabilities on the balance sheet and by disclosing key information about leasing arrangements.  This guidance sets out the principles(2) recognize an impairment charge for the recognition, measurement, presentationamount 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, disclosure of leases for both lessors and lessees. It requires lesseesif it fails such qualitative test, to apply a dual approach, classifying leases as either finance or operating leases based on the principle of whether or not the lease is effectively a financed purchase by the lessee. This classification will determine whether lease expense is recognized based on an effective interest method or on a straight-line basis over the termperform Step 2 of the lease, respectively. A lessee is also required to record a right-of-use asset and a lease liability for all leases with a term greater than 12 months regardless of their classification. Leases with a term of 12 months or less will be accounted for similar to existing guidance for operating leases today. The guidance requires lessors to account for leases using an approach that is substantially equivalent to existing guidance for sales-type leases, direct financing leases and operating leases. This guidance is effective for public companies for fiscal years beginning after December 15, 2017, including interim periods within those fiscal years.  We are currently evaluating the impact that the adoption of this guidance may have on the Company's consolidated financial statements.
9

Triple-S Management Corporation
Notes to Condensed Consolidated Financial Statements
(dollar amounts in thousands, except per share data)
(unaudited)
On March 30, 2016, the FASB issued guidance to reduce complexity in accounting standards.  The areas for simplification involve several aspects of the accounting for share-based payment transactions, including (1) accounting for income taxes, (2) classification of excess tax benefits on the statement of cash flow, (3) forfeitures; (4) minimum statutory tax withholding requirements, (5) classification of employee taxes paid on the statement of cash flows when an employer withholds shares for tax withholding purposes:, (6) the practical expedient for estimating the expected term, and (7) intrinsic value.goodwill impairment test.  For public companies, these amendments, are effective for fiscal years beginning after December 15, 2016, including interim periods within those fiscal years.  We are currently evaluating the impact the adoption of this guidance may havewhich should be applied on the Company's consolidated financial statements.

On May 9, 2016, the FASB issued guidance which affects only the narrow aspects of guidance related to revenue from contracts with customers that include: (1) clarification of the collectibility criterion and the addition of a new criterion to clarify when revenue would be recognized for a contract that fails to meet the criteria in step 1 of the core principle of the guidance (i.e., identifying the contracts with a customer); (2) presentation of sales taxes and similar taxes collected from customers; (3) non-cash consideration; (4) contract modifications at transition; (5) completed contracts at transition; and (6) clarification that an entity that retrospectively applies in the guidance to each prior reporting period is not required to disclose the effect of the accounting change for the period of adoption, but is still required to disclose the effect of the changes on any prior periods retrospectively adjusted. For public companies, these amendments are effective for fiscal years beginning after December 15, 2017, 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.

On June 16, 2016, the FASB issued guidance to provide financial statement users with more decision-useful information about the expected credit losses on financial instruments and other commitments to extend credit held by a reporting entity at each reporting date by replacing the incurred loss impairment methodology in current U.S. GAAP with a methodology that reflects expected credit losses and requires consideration of a broader range of reasonable and supportable information to inform credit loss estimates.  For public companies, these amendmentsprospective 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'sCompany’s consolidated financial statements.

On August 26, 2016, the FASB issued guidance to addresses stakeholders’ concerns regarding diversity in practice in how certain cash receipts and cash payments are presented and classified in the statement of cash flows under, Statement of Cash Flows, and other Topics.  In particular, the guidance addresses eight specific cash flow issues in an effort to reduce this diversity in practice: (1) debt prepayment or debt extinguishment costs; (2) settlement of zero-coupon bonds; (3) contingent consideration payments made after a business combination; (4) proceeds from the settlement of insurance claims; (5) proceeds from the settlement of corporate-owned life insurance policies, including bank-owned life insurance policies; (6) distributions received from equity method investees; (7) beneficial interests in securitization transactions; and (8) separately identifiable cash flows and application of the predominance principle.  For public companies, these amendments are effective for fiscal years beginning after December 15, 2017, 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 and nine months ended September 30, 2016March 31, 2017 that could have a material impact on the Corporation’s financial position, operating results or financials statement disclosures.

109

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 September 30, 2016March 31, 2017 and December 31, 2015,2016, were as follows:
 
 September 30, 2016  March 31, 2017 
 
Amortized
cost
  
Gross
unrealized
gains
  
Gross
unrealized
losses
  
Estimated
fair value
  
Amortized
cost
  
Gross
unrealized
gains
  
Gross
unrealized
losses
  
Estimated
fair value
 
Securities available for sale:                        
Fixed maturities:                        
Obligations of government- sponsored enterprises $59,423  $512  $-  $59,935 
Obligations of government-sponsored enterprises $41,485  $61  $-  $41,546 
U.S. Treasury securities and obligations of U.S. government instrumentalities  77,790   948   (2)  78,736   72,723   169   (14)  72,878 
Obligations of the Commonwealth of Puerto Rico and its instrumentalities  17,624   3,248   -   20,872   18,248   857   (37)  19,068 
Municipal securities  687,107   55,639   (37)  742,709   651,091   34,191   (304)  684,978 
Corporate bonds  226,761   20,642   (93)  247,310   279,540   12,457   (367)  291,630 
Residential mortgage-backed securities  728   43   -   771   638   29   -   667 
Collateralized mortgage obligations  11,823   61   (8)  11,876   42,919   83   (224)  42,778 
Total fixed maturities  1,081,256   81,093   (140)  1,162,209   1,106,644   47,847   (946)  1,153,545 
Equity securities - Mutual funds  262,314   39,968   (205)  302,077   236,356   40,910   (117)  277,149 
Total $1,343,570  $121,061  $(345) $1,464,286  $1,343,000  $88,757  $(1,063) $1,430,694 
 
1110

Triple-S Management Corporation
Notes to Condensed Consolidated Financial Statements
(dollar amounts in thousands, except per share data)
(unaudited)
  December 31, 2015 
  
Amortized
cost
  
Gross
unrealized
gains
  
Gross
unrealized
losses
  
Estimated
fair value
 
Securities available for sale:            
Fixed maturities:            
Obligations of government- sponsored enterprises $115,965  $301  $(26) $116,240 
U.S. Treasury securities and obligations of U.S. government instrumentalities  163,322   234   (286)  163,270 
Obligations of the Commonwealth of Puerto Rico and its instrumentalities  25,302   317   -   25,619 
Municipal securities  612,225   35,418   (197)  647,446 
Corporate bonds  148,198   9,782   (572)  157,408 
Residential mortgage-backed securities  883   54   -   937 
Collateralized mortgage obligations  22,363   368   (6)  22,725 
Total fixed maturities  1,088,258   46,474   (1,087)  1,133,645 
Equity securities - Mutual funds  169,593   27,851   (373)  197,071 
Total $1,257,851  $74,325  $(1,460) $1,330,716 

  September 30, 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  $224  $-  $843 
Residential mortgage-backed securities  191   20   -   211 
Certificates of deposit  2,023   -   -   2,023 
Total $2,833  $244  $-  $3,077 
12

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 

11
  December 31, 2015 
  
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 $620  $178  $-  $798 
Residential mortgage-backed securities  191   17   -   208 
Certificates of deposit  2,118   -   -   2,118 
Total $2,929  $195  $-  $3,124 

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 September 30, 2016March 31, 2017 and December 31, 20152016 were as follows:
  September 30, 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                           
U.S. Treasury securities and obligations of U.S. governmental instrumentalities $2,497  $(2)  1  $-  $-   -  $2,497  $(2)  1 
Municipal securities  13,251   (37)  2   -   -   -   13,251   (37)  2 
Corporate bonds  26,644   (93)  7   -   -   -   26,644   (93)  7 
Collateralized mortgage obligations  5,561   (4)  4   940   (4)  1   6,501   (8)  5 
Total fixed maturities  47,953   (136)  14   940   (4)  1   48,893   (140)  15 
Equity securities-Mutual funds  7,958   (205)  5   -   -   -   7,958   (205)  5 
Total for securities available for sale $55,911  $(341)  19  $940  $(4)  1  $56,851  $(345)  20 

 December 31, 2015  March 31, 2017 
 Less than 12 months  12 months or longer  Total  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
 
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                           
Securities available for sale                           
Fixed maturities                                                      
Obligations of government- sponsored enterprises $18,989  $(26)  1  $-  $-   -  $18,989  $(26)  1 
U.S. Treasury securities and obligations of U.S. governmental instrumentalities  130,996   (286)  5   -   -   -   130,996   (286)  5  $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  43,937   (197)  11   -   -   -   43,937   (197)  11   64,518   (304)  9   -   -   -   64,518   (304)  9 
Corporate bonds  35,718   (572)  9   -   -   -   35,718   (572)  9   84,093   (367)  18   -   -   -   84,093   (367)  18 
Collateralized mortgage obligations  1,448   (6)  1   -   -   -   1,448   (6)  1   26,043   (222)  6   665   (2)  1   26,708   (224)  7 
Total fixed maturities  231,088   (1,087)  27   -   -   -   231,088   (1,087)  27   200,298   (944)  40   665   (2)  1   200,963   (946)  41 
Equity securities-Mutual funds  9,319   (373)  2   -   -   -   9,319   (373)  2   2,831   (49)  4   2,006   (68)  1   4,837   (117)  5 
Total for securities available for sale $240,407  $(1,460)  29  $-  $-   -  $240,407  $(1,460)  29  $203,129  $(993)  44  $2,671  $(70)  2  $205,800  $(1,063)  46 
 
1312

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 and Corporate bonds:Securities:  The unrealized losses on the Corporation’s investments in obligations of U.S. Government Instrumentalities and Municipal Securities and Corporate bonds 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.
13

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 September 30, 2016,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.  During the nine months ended September 30, 2016, positions with a total fair market value of $11,582 were impaired by $1,434.  There were no impairment on mutual funds during the three months ended September 30,March 31, 2017 and 2016.  During the three months and nine months ended September 30, 2015, we recorded an other-than-temporary impairment related to mutual funds amounting to $479.

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 $7,787 and a gross unrealized gain of $15, and (2) bonds issued by the Puerto Rico Sales Tax Financing Corporation (Cofina) with a fair value of $13,085 and a gross unrealized gain of $3,233.

Besides holdings in escrowed bonds, which are backed by US Government securities and therefore have an implicit AA+/Aaa rating, our exposure is in senior lien bonds issued by Cofina. 

There was no impairment on Cofina during the three months and nine months ended September 30, 2016.  During the three and nine months ended September 30, 2015, we recorded an other-than-temporary impairment related to these positions amounting to $1,148 and $4,010, respectively.
14

Triple-S Management Corporation
Notes to Condensed Consolidated Financial Statements
(dollar amounts in thousands, except per share data)
(unaudited)
 
Maturities of investment securities classified as available for sale and held to maturity were as follows:
 
 September 30, 2016  March 31, 2017 
 Amortized
cost
  
Estimated
fair value
  
Amortized
cost
  
Estimated
fair value
 
Securities available for sale:            
Due in one year or less $18,504  $18,666  $48,742  $48,946 
Due after one year through five years  337,657   344,781   322,122   325,519 
Due after five years through ten years  120,438   133,079   131,128   137,138 
Due after ten years  592,106   653,036   561,095   598,497 
Residential mortgage-backed securities  728   771   638   667 
Collateralized mortgage obligations  11,823   11,876   42,919   42,778 
 $1,081,256  $1,162,209  $1,106,644  $1,153,545 
Securities held to maturity:                
Due in one year or less $2,023  $2,023  $1,704  $1,704 
Due after ten years  619   843   619   779 
Residential mortgage-backed securities  191   211   191   209 
 $2,833  $3,077  $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.

Information regarding realized and unrealized gains and losses from investments is as follows:
  
Three months ended
September 30,
  
Nine months ended
September 30,
 
Securities available for sale: 2016  2015  2016  2015 
Realized gains (losses):            
Securities available for sale:            
Fixed maturity securities:            
Gross gains from sales $187  $868  $2,060  $7,205 
Gross losses from sales  (20)  (136)  (1,482)  (540)
Gross losses from other-than-temporary impairments  -   (1,148)  -   (4,010)
Total fixed maturity securities  167   (416)  578   2,655 
Equity securities:                
Gross gains from sales  5,873   126   8,985   14,000 
Gross losses from sales  (664)  (792)  (1,175)  (917)
Gross losses from other-than-temporary impairments  -   (479)  (1,434)  (479)
Total equity securities  5,209   (1,145)  6,376   12,604 
Net realized gains (losses) on securities available for sale $5,376  $(1,561) $6,954  $15,259 
 
1514

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
September 30,
  
Nine months ended
September 30,
 
  2016  2015  2016  2015 
Changes in net unrealized gains (losses):            
Recognized in accumulated other comprehensive income:          
Fixed maturities – available for sale $(5,762) $6,379  $35,566  $(13,378)
Equity securities – available for sale  2,608   (12,018)  12,285   (24,891)
  $(3,154) $(5,639) $47,851  $(38,269)
 Not recognized in the consolidated financial statements:                
Fixed maturities – held to maturity $(14) $15  $49  $(5)
  
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 asset (liability)liability on unrealized gains (losses) change recognized in accumulated other comprehensive income during the ninethree months ended September 30,March 31, 2017 and 2016 and 2015 was ($14,328)$2,136 and $6,1989,781, respectively.

As of September 30, 2016March 31, 2017 and December 31, 2015,2016, no individual investment in securities exceeded 10% of stockholders’ equity.

15

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 as of September 30, 2016, and December 31, 2015 were as follows:

 
September 30,
2016
  
December 31,
2015
  
March 31,
2017
  
December 31,
2016
 
Premium $137,064  $92,600  $100,691  $91,528 
Self-funded group receivables  60,094   73,552   50,643   57,728 
FEHBP  12,421   13,859   14,274   14,321 
Agent balances  26,463   25,424   27,468   25,495 
Accrued interest  11,325   12,624   11,338   13,668 
Reinsurance recoverable  58,076   48,506   54,854   58,295 
Other  67,153   53,325   65,152   62,637 
  372,596   319,890   324,420   323,672 
Less allowance for doubtful receivables:                
Premium  29,950   28,944   23,584   27,320 
Other  8,682   8,300   7,999   9,987 
  38,632   37,244   31,583   37,307 
Total premium and other receivables, net $333,964  $282,646  $292,837  $286,365 

As of September 30, 2016March 31, 2017 and December 31, 2015,2016, the Company had premiums and other receivables of $112,020$51,533 and $78,230,$57,750, respectively, from the Government of Puerto Rico, including its agencies, municipalities and public corporations.  The related allowance for doubtful receivables as of September 30, 2016March 31, 2017 and December 31, 20152016 were $20,558$14,050 and $19,133,$18,812, respectively.
 
16

Triple-S Management Corporation
Notes to Condensed Consolidated Financial Statements
(dollar amounts in thousands, except per share data)
(unaudited)

(5)Fair Value Measurements

Assets recorded at fair value in theOur 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 categorized based uponmeasured 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 level of judgment associated with the inputsmethods and assumptions that are used to measure their fair value.  Level inputs, as defined by current accounting guidance forestimate the fair value measurements and disclosures, are as follows:
Level Input:Input Definition:
Level 1Inputs are unadjusted, quoted prices for identical assets or liabilities in active markets atdetermine the measurement date.
Level 2Inputs other than quoted prices included in Level 1 that are observable for the asset or liability through corroboration with market data at the measurement date.
Level 3Unobservable inputs that reflect management’s best estimate of what market participants would use in pricing the asset or liability at the measurement date.
The Corporation uses observable inputs when available. Fair value is based upon quoted market prices when available. The Corporation limits valuation adjustments to those deemed necessary to ensure that the security’s fair value adequately representshierarchy classification of each class of financial instrument, see the price that would be received or paid in the marketplace. Valuation adjustments may include consideration of counterparty credit qualityconsolidated financial statements and liquidity as well as other criteria.  The estimated fair value amounts are subjective in nature and may involve uncertainties and matters of significant judgment for certain financial instruments. Changes in the underlying assumptions used in estimating fair value could affect the results.  The fair value measurement levels are not indicative of risk of investment.

The fair value of investment securities is estimated based on quoted market prices for those or similar investments.  Additional information pertinent to the estimated fair value of investment in securities isnotes thereto included in note 3.our 2016 Form 10-K.

The following tables summarize fair value measurements by level at September 30, 2016 and December 31, 2015 for assets measured at fair value on a recurring basis:
 
 September 30, 2016  March 31, 2017 
 Level 1  Level 2  Level 3  Total  Level 1  Level 2  Level 3  Total 
Securities available for sale:                        
Fixed maturity securities                        
Obligations of government-sponsored enterprises $-  $59,935  $-  $59,935  $-  $41,546  $-  $41,546 
U.S. Treasury securities and obligations of U.S government instrumentalities  78,736   -   -   78,736 72,878-   -   72,878 
Obligations of the Commonwealth of Puerto Rico and its instrumentalities  -   20,872   -   20,872 -19,068   -   19,068 
Municipal securities  -   742,709   -   742,709   -   684,978   -   684,978 
Corporate bonds  -   247,310   -   247,310   -   291,630   -   291,630 
Residential agency mortgage-backed securities  -   771   -   771   -   667   -   667 
Collateralized mortgage obligations  -   11,876   -   11,876   -   42,778   -   42,778 
Total fixed maturities  78,736   1,083,473   -   1,162,209   72,878   1,080,667   -   1,153,545 
Equity securities - Mutual funds  205,924   69,700   26,453   302,077   174,593   78,803   23,753   277,149 
Total $284,660  $1,153,173  $26,453  $1,464,286  $247,471  $1,159,470  $23,753  $1,430,694 
 
17

Triple-S Management Corporation
Notes to Condensed Consolidated Financial Statements
(dollar amounts in thousands, except per share data)
(unaudited)

  December 31, 2015 
  Level 1  Level 2  Level 3  Total 
Securities available for sale:            
Fixed maturity securities            
Obligations of government-sponsored enterprises  -   116,240   -   116,240 
U.S. Treasury securities and obligations of U.S government instrumentalities  163,270   -   -   163,270 
Obligations of the Commonwealth of Puerto Rico and its instrumentalities  -   25,619   -   25,619 
Municipal securities  -   647,446   -   647,446 
Corporate bonds  -   157,408   -   157,408 
Residential agency mortgage-backed securities  -   937   -   937 
Collateralized mortgage obligations  -   22,725   -   22,725 
Total fixed maturities  163,270   970,375   -   1,133,645 
Equity securities - Mutual funds  167,082   22,031   7,958   197,071 
Total $330,352  $992,406  $7,958  $1,330,716 
The fair value of fixed maturity and equity securities included in the Level 2 category were based on market values obtained from independent pricing services, which utilize evaluated pricing models that vary by asset class and incorporate available trade, bid and other market information and for structured securities, cash flow and when available loan performance data.  Because many fixed income securities do not trade on a daily basis, the models used by independent pricing service providers to prepare evaluations apply available information, such as benchmark curves, benchmarking of like securities, sector groupings, and matrix pricing.  For certain equity securities, quoted market prices for the identical security are not always available and the fair value is estimated by reference to similar securities for which quoted prices are available.  The independent pricing service providers monitor market indicators, industry and economic events, and for broker-quoted only securities, obtain quotes from market makers or broker-dealers that they recognize to be market participants. The fair value of the investments in partnerships included in the Level 3 category was based on the net asset value (NAV) which is affected by the changes in the fair market value of the investments held in these partnerships.
  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 

Transfers into or out of the Level 3 category occur when unobservable inputs, such as the Company’s best estimate of what a market participant would use to determine a current transaction price, become more or less significant to the fair value measurement.  Transfers between levels, if any, are recorded as of the actual date of the event or change in circumstance that caused the transfer.  There were no transfers in and/or out of Level 3 and between Levels 1 and 2 during the three months ended March 31, 2017 and nine months ended September 30, 2016 and 2015.2016.
 
1817

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 and nine months ended September 30March 31 is as follows:

 
Fair Value Measurements Using Significant
Unobservable Inputs (Level 3)
 
 
Three months ended
September 30,
  
Nine months ended
September 30,
  
Fair Value Measurements
Using Significant
Unobservable Inputs (Level 3)
 
 2016  2015  2016  2015  2017  2016 
Beginning balance $14,869  $9,083  $7,958  $13,349  $27,532  $7,958 
Realized gains  21   125   234   1,537   119   151 
Unrealized in other accumulated comprehensive income  (485)  18   (1,454)  (3,284)  (64)  (649)
Purchases  12,587   125   21,220   314   5,260   8 
Capital distributions  (539)  (175)  (1,505)  (2,740)  (9,094)  (471)
Ending balance $26,453  $9,176  $26,453  $9,176  $23,753  $6,997 

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

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

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

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

(i)Policy Loans

Policy loans have no stated maturity dates and are part of the related insurance contract. The carrying amount of policy loans approximates fair value because their interest rate is reset periodically in accordance with current market rates.

(ii)Policyholder Deposits

The fair value of policyholder deposits is the amount payable on demand at the reporting date, and accordingly, the carrying value amount approximates fair value.

(iii)Long-term Borrowings

The carrying amount of the loans payable to bank – variable approximates fair value due to its floating interest-rate structure.  The fair value of the senior unsecured notes payable was determined using broker quotations.
Triple-S Management Corporation
Notes to Condensed Consolidated Financial Statements
(dollar amounts in thousands, except per share data)
(unaudited)

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 September 30, 2016March 31, 2017 and December 31, 20152016 are as follows:
 
 September 30, 2016  March 31, 2017 
 Carrying  Fair Value  
Carrying
Value
   Fair Value 
 Value  Level 1  Level 2  Level 3  Total Level 1  Level 2  Level 3  Total 
Assets:                              
Policy loans $8,372  $-  $8,372  $-  $8,372  $8,546  $-  $8,546  $-  $8,546 
                                        
Liabilities:                                        
Policyholder deposits $181,323  $-  $181,323  $-  $181,323  $179,599  $-  $179,599  $-  $179,599 
Long-term borrowings:                                        
Loans payable to bank - variable  11,597   -   11,597   -   11,597   34,465   -   34,465   -   34,465 
6.6% senior unsecured notes payable  24,000   -   19,200   -   19,200 
Total long-term borrowings  35,597   -   30,797   -   30,797   34,465   -   34,465   -   34,465 
Total liabilities $216,920  $-  $212,120  $-  $212,120  $214,064  $-  $214,064  $-  $214,064 

 December 31, 2015  December 31, 2016 
 Carrying  Fair Value  
Carrying
Value
   Fair Value 
 Value  Level 1  Level 2  Level 3  Total Level 1  Level 2  Level 3  Total 
Assets:                              
Policy loans $7,901  $-  $7,901  $-  $7,901  $8,564  $-  $8,564  $-  $8,564 
                                        
Liabilities:                                        
Policyholder deposits $179,287  $-  $179,287  $-  $179,287  $179,382  $-  $179,382  $-  $179,382 
Long-term borrowings:                                        
Loans payable to bank - variable  12,827   -   12,827   -   12,827   11,187   -   11,187   -   11,187 
6.6% senior unsecured notes payable  24,000   -   19,920   -   19,920   24,000   -   24,000   -   24,000 
Total long-term borrowings  36,827   -   32,747   -   32,747   35,187   -   35,187   -   35,187 
Total liabilities $216,114  $-  $212,034  $-  $212,034  $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

The activity inA reconciliation of the beginning and ending balances of claim liabilities is as follows:

 
Three months ended
September 30,
  
Nine months ended
September 30,
  
Three months ended
March 31, 2017
 
 2016  2015  2016  2015  
Managed
Care
  
Other
Business
Segments *
  Consolidated 
Claim liabilities at beginning of period $481,864  $462,186  $491,765  $390,086 
         
Claim liabilities at beginning of year $349,047  $138,896  $487,943 
Reinsurance recoverable on claim liabilities  (38,109)  (39,156)  (40,714)  (40,635)  -   (38,998)  (38,998)
Net claim liabilities at beginning of period  443,755   423,030   451,051   349,451 
Incurred claims and loss-adjustment expenses:                
Net claim liabilities at beginning of year  349,047   99,898   448,945 
Claims incurred            
Current period insured events  615,125   631,135   1,878,029   1,700,653   602,620   28,226   630,846 
Prior period insured events  6,908   (2,315)  (20,619)  (13,597)  (15,340)  (1,333)  (16,673)
Total  622,033   628,820   1,857,410   1,687,056   587,280   26,893   614,173 
Payments of losses and loss-adjustment expenses:                
Payments of losses and loss-adjustment expenses            
Current period insured events  570,110   561,269   1,540,182   1,345,082   350,450   7,965   358,415 
Prior period insured events  23,728   56,699   296,329   257,543   192,352   17,945   210,297 
Total  593,838   617,968   1,836,511   1,602,625   542,802   25,910   568,712 
Net claim liabilities at end of period  471,950   433,882   471,950   433,882 
Net claim liabilities at end of year  393,525   100,881   494,406 
Reinsurance recoverable on claim liabilities  39,427   39,099   39,427   39,099   -   35,898   35,898 
Claim liabilities at end of period $511,377  $472,981  $511,377  $472,981 
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 amount in the incurred claims and loss-adjustment expenses for the prior period insured events for the three months ended September 30, 2016 is due primarily to higher than anticipated utilization trends.  The favorable developments in the claims incurred and loss-adjustment expenses for prior period insured events for the ninethree months ended September 30,March 31, 2017 and 2016 and for the three months and nine months ended September 30, 2015 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 $7,136$6,690 and $20,540$6,762 during the three months and nine months ended September 30,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 changefollowing is information about total incurred but not reported (IBNR) liabilities plus expected development on reported claims included in the liability for future policy benefits duringunpaid claims adjustment expenses for the three months and nine months ended September 30, 2015 amounted to $6,089 and $18,181, respectively.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 March 11,December 28, 2016, Triple-S Salud, Inc. (TSS)TSM entered into a $30,000 revolving loan$35,500 credit agreement with a commercial bank in Puerto Rico. This lineThe agreement consists of credit, unused asthree term loans: (i) Term Loan A in the principal amount of September 30, 2016, has an interest rate$11,187, (ii) Term Loan B in the principal amount of LIBOR plus 220 basis points, matures$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 MarchJanuary 11, 2017 and containswere 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, that are customary for this type of facility.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)Income Taxes

In connection with the Puerto Rico tax code, as amended, on April 15, 2015, the group of corporations that comprise TSM entered into a Closing Agreement with the Puerto Rico Department of Treasury.  The Closing Agreement, among other matters, was related with the payment of the preferential tax rate on the increase in value of some of its long-term capital assets, as permitted by Act No. 238 of 2014 and Act No. 44 of 2015.  The agreement also covered certain tax attributes of the Corporation.  During the nine months ended September 30, 2016, as a result of the aforementioned tax laws and the Closing Agreement, the Company: (1) obtained a benefit from the lower tax rate provided under these statutes, (2) reassessed the realizability of some of its deferred taxes and (3) recorded a tax benefit of $3,129.

During the nine months ended September 30, 2016, our Property and Casualty subsidiary, Triple-S Propiedad, Inc. (TSP), reassessed the tax rate used to measure several temporary differences, from 20% to 39%, which resulted in an increase in the deferred tax expense of approximately $2,633.

(9)Pension Plan

The components of net periodic benefit cost for the three months and nine months ended September 30March 31 were as follows:
 
 
Three months ended
September 30,
  
Nine months ended
September 30,
  
Three months ended
March 31,
 
 2016  2015  2016  2015  2017  2016 
Components of net periodic benefit cost:                  
Service cost $779  $1,160  $2,907  $3,217  $-  $1,250 
Interest cost  1,874   2,322   6,575   6,544   1,798   2,762 
Expected return on assets  (1,928)  (2,350)  (6,908)  (6,564)  (2,199)  (2,926)
Amortization of prior service benefit  (96)  (126)  (342)  (352)  -   (144)
Amortization of actuarial loss  863   1,665   2,877   4,784   86   1,183 
Net periodic benefit cost $1,492  $2,671  $5,109  $7,629  $(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, 20152016 that it expected to contribute $8,000$4,000 to the pension program in 2016.2017.  As of September 30, 2016,March 31, 2017, the Corporation has contributed $10,000not made contributions to the pension program.

(10)Stock Repurchase Program

The Company repurchases shares through open-market purchases of Class B shares only, in accordance with Rule 10b-18 under the Securities Exchange Act of 1934, as amended, under repurchase programs authorized by the Board of Directors.

In November 2015 the Company’s Board of Directors authorized a $25,000 repurchase program of its Class B common stock.  During the three months ended September 30, 2016, the Company repurchased and retired under this program 299,884 shares at an average per share price of $22.60, for an aggregate cost of $6,825. During the nine months ended September 30, 2016, the Company repurchased and retired under this program 951,831 shares at an average per share price of $22.54, for an aggregate cost of $21,418.  This program was completed on September 14, 2016.
 
Triple-S Management Corporation
Notes to Condensed Consolidated Financial Statements
(dollar amounts in thousands, except per share data)
(unaudited)

(11)(9)Comprehensive Income

The accumulated balances for each classification of other comprehensive income, net of tax, are as follows:
 
 Net Unrealized Gain on Securities  
Three months ended
March 31,
 
 
Three months ended
September 30,
  
Nine months ended
September 30,
  2017  2016 
 2016  2015  2016  2015       
Beginning Balance $97,885  $74,217  $62,478  $101,467 
Net Unrealized Gain on Securities Beginning Balance $62,371  $62,478 
Other comprehensive income before reclassifications  2,417   (5,764)  40,233   (17,269)  8,741   19,623 
Amounts reclassified from accumulated other comprehensive income  (4,301)  943   (6,710)  (14,802)  (269)  (46)
Net current period change  (1,884)  (4,821)  33,523   (32,071)  8,472   19,577 
Ending Balance $96,001  $69,396  $96,001  $69,396   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 

  Liability for Pension Benefits 
  
Three months ended
September 30,
  
Nine months ended
September 30,
 
  2016  2015  2016  2015 
Beginning Balance $(35,776) $(50,926) $(36,855) $(52,691)
Other comprehensive income before reclassifications  -   -   -   - 
Amounts reclassified from accumulated other comprehensive income  466   939   1,545   2,704 
Net current period change  466   939   1,545   2,704 
Ending Balance $(35,310) $(49,987) $(35,310) $(49,987)

  Accumulated Other Comprehensive Income 
  
Three months ended
September 30,
  
Nine months ended
September 30,
 
  2016  2015  2016  2015 
Beginning Balance $62,109  $23,291  $25,623  $48,776 
Other comprehensive income before reclassifications  2,417   (5,764)  40,233   (17,269)
Amounts reclassified from accumulated other comprehensive income  (3,835)  1,882   (5,165)  (12,098)
Net current period change  (1,418)  (3,882)  35,068   (29,367)
Ending Balance $60,691  $19,409  $60,691  $19,409 
Triple-S Management Corporation
Notes to Condensed Consolidated Financial Statements
(dollar amounts in thousands, except per share data)
(unaudited)

(12)(10)Share-Based Compensation

Share-based compensation expense (benefit) recorded during the three months and nine months ended September 30, 2016 was ($383) and $1,931, respectively.  Share-based compensation expense recorded during the three months ended March 31, 2017 and nine months ended September 30,2016 was ($1,443) and $1,085, respectively.  The benefit recorded in the 2017 period results from a decrease in the 2014 and 2015 was $2,321 and $5,520, respectively.  grants expected performance shares payouts.  There waswere no cash received from stock option exercises during the ninethree months ended September 30, 2016March 31, 2017 and 2015.  During the nine months ended September 30, 2016 and 2015, 2,290 and 7,235 shares, respectively, were repurchased and retired as a result of non-cash exercises of stock options.2016.

(13)(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 for the three and nine months ended September 30:share:

 
Three months ended
September 30,
  
Nine months ended
September 30,
  
Three months ended
March 31,
 
 2016  2015  2016  2015  2017  2016 
Numerator for earnings per share:                  
Net (loss) income attributable to TSM available to stockholders $(1,941) $4,194  $5,395  $37,956  $(4,342) $3,456 
Denominator for basic earnings per share:                        
Weighted average of common shares  24,386,076   25,388,077   24,534,647   25,932,049   24,143,261   24,587,681 
Effect of dilutive securities  -   72,983   70,632   88,688   -   72,353 
Denominator for diluted earnings per share  24,386,076   25,461,060   24,605,279   26,020,737   24,143,261   24,660,034 
Basic net (loss) income per share attributable to TSM $(0.08) $0.17  $0.22  $1.46  $(0.18) $0.14 
Diluted net (loss) income per share attributable to TSM $(0.08) $0.16  $0.22  $1.46  $(0.18) $0.14 

No dilutive securities have been included inThe Company generated a loss from continuing operations attributable to the diluted earnings per share calculationCompany’s common stockholders for the three months ended September 30, 2016 due to our reportingMarch 31, 2017, so the effect of a net loss fordilutive securities is not considered because their effect would be antidilutive. If the quarter.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.

(14)(12)Contingencies

The following information supplements and amends, as applicable, the disclosures in Note 24 to the Consolidated Financial Statements of the Company’s 20152016 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'sCompany’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.

Claims by HeirsASES Audits
The Company is subject to numerous audits in connection with the provision of Former Shareholdersservices 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.

InOn 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 entitled Cebollero Santamaría v. Triple-S Salud, Inc., et al, was filed v. Administracion de Seguros de Salud de Puerto Rico. TSS contends that ASES’ request for reimbursement has no merits on March 26, 2013,several grounds, including a 2011 settlement between both parties covering the majority of the amount claimed by ASES, and the Company filed its response on May 16, 2013. On October 29, 2013, the Company filed a motion for summary judgment on the grounds that the claim is time-barredASES, under the fifteen-year statuteterms of limitations ofthe contracts, was responsible for certifying the membership. TSS also amended its claim to include the Puerto Rico Civil CodeHealth Department (PRHD), as it asserts the PRHD is an indispensable party for collectionthe resolution of moniesthis 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 alternative, that plaintiff failedcourt’s decision in connection to state a claim for which relief can be granted, which was deniedthe report issued by the court.  On November 2, 2015, the Company filedSpecial Commissioner. TSS will continue to conduct a petitionvigorous defense of Writthis matter.

In the case entitled Gallardo Mendez, et al, v. Triple-S Management Corporation which was filed on December 30, 2014, the Company filed a motion
Notes to dismiss on March 13, 2015.  After an extension of time granted by the court, plaintiff did not file an opposition.  Therefore, on June 16, 2015, the court deemed our motion to dismiss unopposed. On March 18, 2016, the court dismissed the complaint with prejudice. Since plaintiff did not file within 30 days an appeal brief opposing the trial court’s determination, the dismissal of the case is final.Condensed Consolidated Financial Statements

(dollar amounts in thousands, except per share data)
Claims Relating to the Provision of Health Care Services(unaudited)

On June 5, 2014, ASES initiated an administrative hearing against TSS moved by a primary medical group for alleged outstanding claims related to services provided to Medicaid beneficiaries from 2005 to 2010, totaling approximately $3,000. On June 19, 2014, TSS filed its response.  On June 25, 2014, the hearing officer ordered the parties to file a joint working plan and schedule.  In the process of executing said plan and after discovery was completed, this matter was settled for $316 on June 6, 2016.

(15)(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 Managed Care segment participates in the Commonwealth of Puerto Rico Health Insurance Plan (similar to Medicaid) (Medicaid) program to provide health coverage to medically indigent citizens in Puerto Rico, as defined by the laws of the government of Puerto Rico, by administering the provision of the physical health component in designated service regions in Puerto Rico.  We served all eight service regions on an administrative service only basis (ASO) until March 31, 2015.  During the nine months ended September administrative service fees related to this agreement amounted to $24,367.  Effective April 1, 2015, we started to provide healthcare services to only two regions of the Medicaid program on a risk based model.
Triple-S Management Corporation
Notes to Condensed Consolidated Financial Statements
(dollar amounts in thousands, except per share data)
(unaudited)
 
The following tables summarize the operations by reportable segment for the three and nine months ended September 30, 2016March 31, 2017 and 2015:2016:

 
Three months ended
September 30,
  
Nine months ended
September 30,
  
Three months ended
March 31,
 
 2016  2015  2016  2015  2017  2016 
Operating revenues:                  
Managed Care:                  
Premiums earned, net $660,660  $689,532  $2,007,972  $1,857,216  $640,147  $678,380 
Administrative service fees  4,146   6,163   13,749   39,835   4,379   5,083 
Intersegment premiums/service fees  1,384   (248)  4,521   4,257   1,534   1,485 
Net investment income  3,628   2,727   11,215   8,444   3,892   3,480 
Total managed care  669,818   698,174   2,037,457   1,909,752   649,952   688,428 
Life Insurance:                        
Premiums earned, net  38,729   35,636   116,286   109,661   40,298   38,966 
Intersegment premiums  212   54   551   185   191   137 
Net investment income  6,355   5,840   18,681   17,724   6,087   5,914 
Total life insurance  45,296   41,530   135,518   127,570   46,576   45,017 
Property and Casualty Insurance:                        
Premiums earned, net  21,798   21,550   64,512   66,506   21,548   21,188 
Intersegment premiums  153   153   460   460   153   153 
Net investment income  2,358   1,951   6,612   6,172   1,924   1,929 
Total property and casualty insurance  24,309   23,654   71,584   73,138   23,625   23,270 
Other segments: *                        
Intersegment service revenues  2,502   2,770   7,664   7,932   1,586   2,545 
Operating revenues from external sources  878   905   2,693   2,768   1,000   856 
Total other segments  3,380   3,675   10,357   10,700   2,586   3,401 
Total business segments  742,803   767,033   2,254,916   2,121,160   722,739   760,116 
TSM operating revenues from external sources  7   15   12   45   78   4 
Elimination of intersegment premiums/service fees  (1,749)  41   (5,532)  (4,902)  (1,598)  (1,775)
Elimination of intersegment service revenues  (2,502)  (2,770)  (7,664)  (7,932)  (1,586)  (2,545)
Other intersegment eliminations  (18)  42   (45)  37   -   (13)
Consolidated operating revenues $738,541  $764,361  $2,241,687  $2,108,408  $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 
  
Three months ended
September 30,
  
Nine months ended
September 30,
 
  2016  2015  2016  2015 
Operating (loss) income:            
Managed care $(22,022) $(2,169) $(26,443) $6,288 
Life insurance  4,247   4,300   14,899   14,402 
Property and casualty insurance  4,017   2,593   9,516   6,553 
Other segments *  (894)  (219)  (1,255)  (503)
Total business segments  (14,652)  4,505   (3,283)  26,740 
TSM operating revenues from external sources  7   15   12   45 
TSM unallocated operating expenses  (1,771)  (3,397)  (7,645)  (10,937)
Elimination of TSM intersegment charges  2,382   2,442   7,155   7,237 
Consolidated operating income  (14,034)  3,565   (3,761)  23,085 
Consolidated net realized investment gains (losses)  5,376   (1,561)  6,954   15,259 
Consolidated interest expense  (1,893)  (1,979)  (5,729)  (6,235)
Consolidated other income, net  734   2,289   5,468   5,131 
Consolidated (loss) income before taxes $(9,817) $2,314  $2,932  $37,240 
                 
Depreciation and amortization expense:                
Managed care $2,622  $3,227  $8,395  $9,987 
Life insurance  247   261   751   810 
Property and casualty insurance  91   88   402   278 
Other segments*  160   120   479   365 
Total business segments  3,120   3,696   10,027   11,440 
TSM depreciation expense  197   197   590   591 
Consolidated depreciation and amortization expense $3,317  $3,893  $10,617  $12,031 

*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 
  
September 30,
2016
  
December 31,
2015
 
Assets:      
Managed care $1,165,750  $1,034,725 
Life insurance  830,074   770,721 
Property and casualty insurance  360,314   350,514 
Other segments *  26,064   25,629 
Total business segments  2,382,202   2,181,589 
Unallocated amounts related to TSM:        
Cash, cash equivalents, and investments  2,269   12,304 
Property and equipment, net  22,620   23,219 
Other assets  29,362   31,732 
   54,251   67,255 
Elimination entries-intersegment receivables and others  (61,535)  (42,699)
Consolidated total assets $2,374,918  $2,206,145 

*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)
 
(16)(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.
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 and nine months ended September 30, 2016.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, 20152016 and the MD&A included therein, and our unaudited consolidated financial statements and accompanying notes as of and for the three months and nine months ended September 30, 2016March 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 largestmost significant players in the managed care industry in Puerto Rico withand have over 5055 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 and U.S. Federal Government fundedRico-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 the physical health componentbenefits in designated service regions in Puerto Rico.  We served all eight regions on an administrative service only basis (ASO) until March 31, 2015.  Effective April 1, 2015, the government changed the Medicaid delivery model from ASO to a risk-based model that includes the physical and mental health components. We elected to participate in this sector as a fully-insured provider in only two regions.  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, 20152016 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 September 30, 2016,March 31, 2017, we served approximately 1,038,000 members.��1,016,000 members across all regions of Puerto Rico.  For the ninethree months ended September 30,March 31, 2017 and 2016 and 2015,respectively, our managed care segment represented approximately 92%91% and 91%, respectively,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 Triple-S Blue, Inc. (TSB)TSB are Blue Cross Blue Shield Association (BCBSA) 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. (TSV), 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 1513 of the Condensed Consolidated Financial Statements included in this 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.  Administrativecontracts 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. Operating expenses also includes the Health Insurance Providers Fee paid under the Affordable Care Act (ACA).

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 Update

During recent years,the past decade, Puerto Rico has been facing economic and fiscal challenges and its economy has been contracting.

On  In response to the Commonwealth of Puerto Rico (the Commonwealth) fiscal and economic crisis, on June 30, 2016, the President of the United States signedU.S. Congress enacted the Puerto Rico Oversight, Management and Economic Stability Act (PROMESA)(“PROMESA”), which, grantsamong other things, established a Federally-appointed oversight board (the “Oversight Board”) comprised of seven members with ample powers over the finances of the Commonwealth of Puerto Rico (Commonwealth) and its component units, access to an orderly mechanism to restructure their debts in exchange for significant federal oversight over the Commonwealth’s finances. In general,instrumentalities.  PROMESA seeks to provide Puerto Rico with fiscal and economic discipline through the creation of a control board, relief from creditor lawsuits through the enactment ofalso established a temporary stay on litigation and two alternative methods to adjust unsustainable debt.

On July 1, 2016,enforce rights or remedies related to financial liabilities of the Commonwealth, defaultedits instrumentalities and municipalities, which expired on $911 millionMay 1, 2017.  Finally, PROMESA established two separate mechanisms to restructure the debts of bond payments,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 included $780 millionis modeled after Chapter 9 of General Obligation debt, afterthe 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 evokedsubmitted a local10-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 moratorium provision.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.

On August 31, 2016, the President of the United States appointed the seven members of the FinancialThe Oversight and Management Board also required that certain Commonwealth instrumentalities, such as Government Development Bank for Puerto Rico, (thethe 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) created by PROMESA, which held its first official meeting on September 30, 2016.Board may require other instrumentalities and municipalities to prepare and submit fiscal plans.
On October 10, 2016,May 1, 2017, the temporary stay on litigation established by PROMESA expired. After the expiration of the temporary stay, several hedge funds, which hold General Obligationinvestors 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 a lawsuit againstan order seeking the Commonwealth, demandingprotection of the Commonwealth to discontinue directing sales tax revenues towardsprovisions 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) debt service(“COFINA” by its Spanish acronym), which issued the sales and requestinguse tax-backed bonds. While the court to declare that the General Obligations bondsproceedings under Title III of PROMESA are ongoing, all enforcement and collection actions against the Commonwealth have payment priority over Cofina debt.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.

On October 14, 2016, the Government of Puerto Rico presented the Commonwealth of Puerto Rico Fiscal Plan to the Oversight Board. The fiscal plan, which is subject to the review and approval ofAlthough the Oversight Board includes structural reforms to reducehas not sought the sizeprotection 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,Government’s health plan, ASES may be affected by the deficitCommonwealth’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 spending and proposals to achieve economic growth, while providing forpolicy includes guaranteeing the continuity of public services in essential servicesareas such as healthcare, public safetyhealth, security, education, social work and education.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 September 30, 2016,March 31, 2017, the Company had premiums and other receivables of $112.0$51.5 million from the Government of Puerto Rico, including its agencies, municipalities and public corporations with a related allowance for doubtful receivables of $20.6$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 –Our business is geographically concentrated in Puerto Rico and weakness in the economy and the fiscal health of the government has adversely impacted and may continue to adversely impact us.” andWe are dependent on a small number of government contracts to generate a significant amount of the revenues of our managed care business.business.’’ included in our Annual Report on Form 10-K for the year ended December 31, 2015.2016.

Managed Care –Political and Regulatory Developments
CMS announced final benchmark rates for the 2018 Medicare Advantage

On October 12, 2016, plans.  The call letter included revenue adjustments reflecting the Centersphysician 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 & Medicaid Services (CMS) publishedAdvantage, the STAR Ratingspayment system for payment year 2018.  Contract H5774, the Triple-S Advantage Health Maintenance Organization (HMO) contract, scored 4.0 overall on a 5.0 star rating system, increasing 1.0 versus the prior year, and achieved 5 stars inMedicare Part D all this demonstratingand changes in the methodology and payment policies used by CMS to establish rates could reduce our dedication to providingprofitability and the highest quality of carebenefits we offer our beneficiaries’’ included in our Annual Report on Form 10-K for our members as well as the significant investments we have made in technology and systems.  Contract H4005, the Triple-S Advantage Preferred Provider Organization (PPO) contract, scored 3.5 overall, sustaining the rating from the previous year and achieved 4.5 stars in Part D.   It is worth noting that no plan in Puerto Rico has achieved more than a 4 overall star rating.  Star ratings are calculated annually and are subject to change each 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 September 30,  As of March 31, 
 2016  2015  2017  2016 
Managed care enrollment:            
Commercial 1
  521,994   552,471   505,848   544,846 
Medicare  113,950   124,004   121,352   119,224 
Medicaid  402,358   423,944   389,130   402,933 
Total  1,038,302   1,100,419   1,016,330   1,067,003 
Managed care enrollment by funding arrangement:                
Fully-insured  860,619   919,374   847,327   886,547 
Self-insured  177,683   181,045   169,003   180,456 
Total  1,038,302   1,100,419   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
September 30,
  
Nine months ended
September 30,
  
Three months ended
March 31,
 
(dollar amounts in millions) 2016  2015  2016  2015  2017  2016 
Revenues:                  
Premiums earned, net $721.2  $746.7  $2,188.8  $2,033.4  $702.3  $738.5 
Administrative service fees  4.2   6.2   13.7   39.8   4.4   5.1 
Net investment income  12.3   10.6   36.6   32.5   12.0   11.4 
Other operating revenues  0.9   0.9   2.6   2.7   0.9   0.8 
Total operating revenues  738.6   764.4   2,241.7   2,108.4   719.6   755.8 
Net realized investment gains (losses)  5.4   (1.6)  7.0   15.3 
Net realized investment gains  0.3   - 
Other income, net  0.7   2.3   5.4   5.1   2.6   0.9 
Total revenues  744.7   765.1   2,254.1   2,128.8   722.5   756.7 
Benefits and expenses:                        
Claims incurred  629.2   634.9   1,878.0   1,705.2   620.9   626.7 
Operating expenses  123.4   125.9   367.5   380.1   110.9   123.0 
Total operating expenses  752.6   760.8   2,245.5   2,085.3   731.8   749.7 
Interest expense  1.9   2.0   5.7   6.3   1.7   1.9 
Total benefits and expenses  754.5   762.8   2,251.2   2,091.6   733.5   751.6 
(Loss) income before taxes  (9.8)  2.3   2.9   37.2   (11.0)  5.1 
Income tax benefit  (7.9)  (1.9)  (2.5)  (0.7)
Net (loss) income  (1.9)  4.2   5.4   37.9 
Less: net loss attributable to non-controlling interest  -   -   -   0.1 
Income taxes (benefit) / expense  (6.7)  1.7 
Net (loss) income attributable to TSM $(1.9) $4.2  $5.4  $38.0  $(4.3) $3.4 
Three Months Ended September 30, 2016March 31, 2017 Compared to Three Months Ended September 30, 2015March 31, 2016

Operating Revenues

Consolidated premiums earned, net for the three months ended March 31, 2017 decreased by $25.5$36.2 million, or 3.4%4.9%, to $721.2 million.$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 $28.8$38.2 million mainly due to lower fully-insured membership across all sectors.  This impact is offset in part by anthe segment’s Medicaid and Commercial businesses.
Other Income, Net
The $1.7 million increase in Life Insurance premiums andconsolidated other income reflects the increase in Medicaid premiums resulting from the releasecollection of the accrual of excess profit (previously recorded as accrual return premiums)interest charged for late payment related to the government of Puerto Rico.  This release of the accrual of excess profit is in line with the provisions of thecurrent Medicaid at-risk contract.

Claims Incurred

Consolidated claims incurred decreased by $5.7$5.8 million, or 0.9%, to $629.2$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’ssegment.  The decrease in fully-insured membership, partiallyManaged Care claims primarily reflects lower claims incurred in the segment’s Medicaid and Commercial businesses primarily driven by lower enrollment, offset in part by unfavorable prior period reserve developments across all sectors. Also, we experiencedhigher 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 220350 basis points to 87.2%88.4%.  Excluding the impact
33


Operating Expenses

Consolidated operating expenses during the three months ended March 31, 2017 decreased by $2.5$12.1 million, or 2.0%9.8%, to $123.4 million.$110.9 million as compared to the operating expenses during the three months ended March 31, 2016.  The lower operating expenses reflects a $4.4 million contingency accrual recorded inare mostly the 2015 period and lower personnel costs and professional service fees inresult of the 2016 period.  These decreases were partially offset by an increasedecrease in the Health Insurance Providers Fee reflecting(HIP fee) of $10.8 million due to the at-risk Medicaid enrollment after the model changed in 2015, as well as to a new business-to-business2017 tax implemented in Puerto Rico at the end of the third quarter of 2015.holiday, and lower personnel costs.  For the three months ended September 30, 2016,March 31, 2017, the consolidated operating expense ratio increased 30decreased 80 basis points to 17.0%15.7%.

Income Taxes

Consolidated income tax benefit increasedtaxes decreased by $6.0$8.4 million, to $7.9a benefit of $6.7 million for the three months ended September 30, 2016.March 31, 2017.  The year over year change in income taxes primarily results from thea loss before taxes incurred in the 20162017 period incurred in the Managed Care segment.
 
Nine Months Ended September 30, 2016 Compared to Nine Months Ended September 30, 2015

Operating Revenues

Consolidated premiums earned, net increased by $155.4 million, or 7.6%, to $2.2 billion.  This increase primarily reflects higher premiums in the Managed Care segment by $150.8 million after the change in the Medicaid business model from an ASO agreement to a fully insured model effective April 1, 2015 and higher premium rates in the Commercial business.

The consolidated administrative service fees decreased $26.1 million, or 65.6%, mostly as a result of the previously mentioned change in the Medicaid contract model.  Total administrative fees related to the previous Medicaid ASO agreement during the 2015 period amounted to $24.4 million.

Net investment income increased by $4.1 million, or 12.6%, to $36.6 million mostly as a result of higher invested balances.

Claims Incurred

Consolidated claims incurred increased by $172.8 million, or 10.1%, to $1.9 billion, mostly due to higher claims in the Managed Care segment.  This increase primarily reflects higher claims incurred in the segment’s Medicaid business by $151.9 million after the contract changed to a fully insured model, the impact of Managed Care prior period reserve developments.  The consolidated loss ratio increased by 190 basis points to 85.8%.  Excluding the impact of prior period development, as well as moving the 2015 risk score revenue adjustments to its corresponding period, consolidated loss ratio was 85.5%, 60 basis points higher than last year.

Operating Expenses

Consolidated operating expenses decreased by $12.6 million, or 3.3%, to $367.5 million.  The decrease reflects lower expenses following the change in the Medicaid membership after we elected to decrease the number of regions we serve, from eight regions under an ASO agreement to only two regions when the contract changed to a fully-insured model.  The lower operating expenses also reflect a decrease in the provision for doubtful accounts, mostly due to the strengthening of the allowance for doubtful receivables in the 2015 period, as well as a $4.4 million contingency accrual recorded in 2015.  These decreases were partially offset by a new business-to-business tax implemented in Puerto Rico at the end of the third quarter 2015 and an increase in the Health Insurance Providers Fee, reflecting the at-risk Medicaid enrollment after the model changed in 2015.  For the nine months ended September 30, 2016, the consolidated operating expense ratio decreased 160 basis points to 16.7%, as the result of the increase in premiums and lower expenses.

Income Taxes

Consolidated income tax benefit increased by $1.8 million, to $2.5 million.  The higher tax benefit primarily results from the net effect of the following:

·
For the 2016 period the Managed Care segment, which has a higher effective tax rate than our other segments, incurred in a loss before taxes, resulting in the recording of a tax benefit during the period.

·
During the 2015 period, the Company executed a Closing Agreement between TSM and its subsidiaries and the Puerto Rico Treasury Department in connection with a local law that provided a temporary preferential tax rate in capital asset transactions.  These events allowed the Company to record a $3.1 million benefit in the 2015 period resulting from the enacted lower taxable rate and the reassessment of the realizability of some of its deferred taxes.

·The Property and Casualty segment reassessed the tax rate used to measure several temporary differences; as a consequence such rate was increased from 20% to 39%, resulting in an increase to its deferred tax expense of approximately $2.6 million.
Managed Care Operating Results

 
Three months ended
September 30,
  
Nine months ended
September 30,
  
Three months ended
March 31,
 
(dollar amounts in millions) 2016  2015  2016  2015  2017  2016 
Operating revenues:                  
Medical premiums earned, net:                  
Commercial $206.3  $210.6  $636.8  $634.9  $205.1  $215.5 
Medicare  255.3   279.4   789.4   818.0   257.7   261.0 
Medicaid  199.4   199.8   582.8   405.3   177.7   202.2 
Medical premiums earned, net  661.0   689.8   2,009.0   1,858.2   640.5   678.7 
Administrative service fees  5.2   5.6   17.3   43.2   5.6   6.3 
Net investment income  3.6   2.7   11.2   8.4   3.9   3.5 
Total operating revenues  669.8   698.1   2,037.5   1,909.8   650.0   688.5 
Medical operating costs:                        
Medical claims incurred  598.0   605.5   1,784.5   1,614.0   587.3   596.3 
Medical operating expenses  93.8   94.8   279.4   289.5   81.3   92.8 
Total medical operating costs  691.8   700.3   2,063.9   1,903.5   668.6   689.1 
Medical operating (loss) income $(22.0) $(2.2) $(26.4) $6.3 
Medical operating loss $(18.6) $(0.6)
Additional data:                        
Member months enrollment:                        
Commercial:                        
Fully-insured  1,039,842   1,119,344   3,199,546   3,388,436   1,013,205   1,096,282 
Self-funded  534,653   544,881   1,617,900   1,680,435   507,167   543,026 
Total Commercial member months  1,574,495   1,664,225   4,817,446   5,068,871 
                
Medicare member months  344,167   370,702   1,059,702   1,073,726 
                
Medicaid:                
Fully-insured  1,205,792   1,279,692   3,634,029   2,583,204 
Self-insured  -   -   -   4,229,082 
Total Medicaid member months  1,205,792   1,279,692   3,634,029   6,812,286 
Total Commercial  1,520,372   1,639,308 
Medicare  363,727   364,427 
Medicaid  1,173,273   1,221,892 
Total member months  3,124,454   3,314,619   9,511,177   12,954,883   3,057,372   3,225,627 
Medical loss ratio  90.5%  87.8%  88.8%  86.9%  91.7%  87.9%
Operating expense ratio  14.1%  13.6%  13.8%  15.2%  12.6%  13.5%

Three Months Ended September 30, 2016March 31, 2017 Compared to Three Months Ended September 30, 2015March 31, 2016

Medical Operating Revenues

Medical premiums earned for the three months ended September 30, 2016March 31, 2017 decreased by $28.8$38.2 million, or 4.2%5.6%, to $661.0 million.$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:

·Medicare premiums decrease of $24.1 million, or 8.6%, primarily results from lower member months enrollment when compared to 2015 combined with a 2.4% average reduction in 2016 Medicare reimbursement rates.
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.

·Commercial premiums decrease of $4.3 million, or 2.0%, primarily results from a decrease in fully-insured member months enrollment, partially offset by an approximately 5% year over year increase in average premium rates.

·Medicaid premiums decreased by $0.4 million, or 0.2% primarily as the result of a lower member months enrollment, reflecting the population decline in Puerto Rico, and the lower average premium rates negotiated with the government of Puerto Rico that went into effect July 1, 2016.  These decreases are partially offset by a $15.6 million increase in the Medicaid premiums resulting from a partial reduction of the accrual of excess profit, which was driven by the previously mentioned decrease in premium rates and higher utilization trends.
 
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 $7.5$9.0 million, or 1.2%1.5%, to $598.0 million.$587.3 million when compared to the three months ended March 31, 2016.  The medical loss ratio (MLR) of the segment increased 270380 basis points during the 20162017 period, to 90.5%91.7%.  This fluctuation is primarily attributed to the net effect of the following:

·The medical claims incurred of the Medicaid business decreased by $6.0 million during the 2016 period primarily reflecting the net effect of the previously described decrease in member months enrollment partially offset by higher pharmacy and outpatient trends.
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 Medicare business decreased by $2.5 million, or 1.0%, during the 2016 period reflecting the previously mentioned decrease in membership and changes in benefit design included in 2016 products as the result of the decrease in reimbursement rates.  This decrease is offset by unfavorable prior period reserve developments related to previous quarters. Adjusting for the effect of prior period reserve developments, and moving risk score revenue adjustments to their corresponding periods, our Medicare MLR would have been approximately 87.1% this quarter, about 180 basis points higher than last year, mostly driven by increased Part B drug costs, mainly related to cancer and rheumatoid arthritis and the decrease in premium rates reimbursements from CMS.
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 Commercial business increased by $1.0 million, or 0.6%, during the 2016 period.  This increase mostly reflects the impact of unfavorable prior period reserve developments.  Excluding the effect of prior period reserve developments in 2016 and 2015, the MLR would have decreased by 270 basis points to 83.4%, reflecting the continuity of our underwriting discipline and premium trends higher than claims trends.
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 decreased by $1.0 million, or 1.1%, to $93.8 million.  The lower operating expenses reflect a $4.4 million contingency accrual recorded in the 2015 period, and lower professional service fees in the 2016 period.  These decreases were partially offset by an increase in the Health Insurance Providers Fee, reflecting the at-risk Medicaid enrollment after the model changed in 2015, as well as to a new business-to-business tax implemented in Puerto Rico at the end of the third quarter of 2015.  Forfor the three months ended September 30, 2016, the operating expense ratio increased 50 basis points to 14.1%.

Nine Months Ended September 30, 2016 Compared to Nine Months Ended September 30, 2015

Medical Operating Revenues

Medical premiums earned increasedMarch 31, 2017 decreased by $150.8$11.5 million, or 8.1%,12.4 %, to $2.0 billion.  This increase is principally the result of the following:

·Medical premiums generated by the Medicaid business increased by $177.5 million to $582.8 million, primarily as the result of the change in the Medicaid service model, from an ASO agreement to a fully-insured model effective April 1, 2015.

·Medical premiums generated by the Commercial business increased by $1.9 million, or 0.3%, to $636.8 million.  This fluctuation is primarily the result of approximately 6% year over year increase in average premium rates, partially offset by a decrease in fully insured member month enrollment.

·Medical premiums generated by the Medicare business decreased by $28.6 million, or 3.5%, to $789.4 million.  This fluctuation primarily results from lower risk score revenue as$81.3 million when compared with 2015, lower member months enrollment, and a reduction in 2016 Medicare reimbursement rates.

Administrative service fees decreased by $25.9 million, or 60.0%, to $17.3 million mainly due to the previously mentioned change in the Medicaid contract effective April 1, 2015.
Medical Claims Incurred

Medical claims incurred increased by $170.5 million, or 10.6%, to $1.8 billion.  The MLR of the segment increased 190 basis points during the 2016 period, to 88.8%.  These fluctuations are primarily attributed to the net effect of the following:

·
The medical claims incurred of the Medicaid business increased by $151.9 million during the 2016 period reflecting the previously mentioned change in the Medicaid contract effective April 1, 2015. 

·The medical claims incurred of the Commercial business increased by $13.8 million, or 2.6%, during 2016, mostly reflecting the impact of prior period reserve developments, partially offset by lower member months enrollment.  The Commercial MLR was 86.4%, which is 200 basis points higher than the MLR for the prior year.  Excluding the effect of prior period reserve developments in 2016 and 2015, the MLR would have decreased by 150 basis points, reflecting the continuity of our underwriting discipline and premium trends higher than claims trends.

·The medical claims incurred of the Medicare business increased by $4.8 million, or 0.7%, during 2016 and its MLR was 90.0%, which is 370 basis points higher than the MLR for the prior period.  Adjusting for the effect of prior period reserve developments, and moving the 2015 final risk score revenue adjustments to its corresponding period, our Medicare MLR would have been 90.2%, about 310 basis points higher than last year. The higher MLR primarily reflects higher Part B drug costs, mainly related to cancer and rheumatoid arthritis, and the effect of the decrease in 2016 Medicare reimbursement rates.  The impact of the lower reimbursement rates was partially offset by a change in benefit design in the 2016 products.

Medical Operating Expenses

Medical operating expenses decreased by $10.1 million, or 3.5%, to $279.4 million.  The decrease mostly reflects lower expenses following the change in the Medicaid membership after we elected to decrease the number of regions we serve from eight regions under an ASO agreement to only two regions when the contract was changed to a fully-insured model.  The lower operating expenses also includes the effect of a decrease in the provision for doubtful accounts, mostly due to the strengthening of the allowance for doubtful receivables in the 2015 period, as well as to a $4.4 million contingency accrual recorded in 2015.  These decreases were partially offset by a new business-to-business tax implemented in Puerto Rico during the third quarter of 2015 and an increase in the Health Insurance Providers Fee, reflecting the at-risk Medicaid enrollment after the model changed in 2015.three months ended March 31, 2016.  The operating expense ratio decreased 140by 90 basis points to 13.8%12.6% in 2016 as a2017.  The lower operating expenses and expense ratio are mostly the result of the increasedecrease in premiums andthe HIP Fee of $10.7 million due to the 2017 moratorium as well as lower expenses.personnel costs.
 
Life Insurance Operating Results

 
Three months ended
September 30,
  
Nine months ended
September 30,
  
Three months ended
March 31,
 
(dollar amounts in millions) 2016  2015  2016  2015  2017  2016 
Operating revenues:                  
Premiums earned, net:                  
Premiums earned $40.8  $38.2  $120.3  $115.1  $41.8  $39.8 
Assumed earned premiums  0.4   -   3.1   2.2   0.9   1.5 
Ceded premiums earned  (2.3)  (2.5)  (6.6)  (7.4)  (2.2)  (2.2)
Premiums earned, net  38.9   35.7   116.8   109.9   40.5   39.1 
Net investment income  6.4   5.8   18.7   17.7   6.1   5.9 
Total operating revenues  45.3   41.5   135.5   127.6   46.6   45.0 
Operating costs:                        
Policy benefits and claims incurred $22.5   19.8   65.8   60.5   23.7   21.4 
Underwriting and other expenses  18.6   17.4   54.8   52.7   19.0   18.0 
Total operating costs  41.1   37.2   120.6   113.2   42.7   39.4 
Operating income $4.2  $4.3  $14.9  $14.4  $3.9  $5.6 
Additional data:                        
Loss ratio  57.8%  55.5%  56.3%  55.1%  58.5%  54.7%
Operating expense ratio  47.8%  48.7%  46.9%  48.0%  46.9%  46.0%

Three Months Ended September 30, 2016March 31, 2017 Compared to Three Months Ended September 30, 2015March 31, 2016

Operating Revenues

Premiums earned, net increased by $3.2$1.4 million, or 9.0%,3.6% to $38.9$40.5 million reflecting improved policy retention and higher sales principallyas the result of premium growth in the segment’s Individual Life and Cancer lines of business, as well as the growth in the Costa Rica operations.

Policy Benefits and Claims Incurred

Policy benefits and claims incurred increased by $2.7$2.3 million, or 13.6%10.7%, to $22.5$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 as well as to an increase in actuarial reserves.and higher number of claims paid.  The loss ratio for the period increased from 55.5%to 58.5% in 2015 to 57.8% in 2016,2017, or 230380 basis points, reflecting the higher volume in the Cancer line of business, which has a higher loss ratio, andas well as to a higher claims experience in the Individual Lifethis particular line of business.

Underwriting and Other Expenses

Increase in underwriting and other expenses of $1.2$1.0 million, or 6.9%5.6%, to $18.6$19.0 million is mostly reflectingreflects higher commissions following the segment’s premium growth mentioned above.  The operating expense ratio decreased 90 basis points from 48.7% in 2015 to 47.8% in 2016, reflecting the increase in premiums during the period.

Nine Months Ended September 30, 2016 Compared to Nine Months Ended September 30, 2015

Operating Revenues

Premiums earned, net increased by $6.9 million, or 6.3% to $116.8 million as the result of premium improved policy retention and higher sales in the segment’s Individual Life and Cancer lines of business, premiums assumed on reinsurance agreements, as well as growth in the Costa Rica operations.

Policy Benefits and Claims Incurred

Policy benefits and claims incurred increased by $5.3 million, or 8.8%, to $65.8 million, mostly reflecting a higher volume of business during the year, particularly in the Cancer line of business, and in premiums assumed under reinsurance agreements, which carry a higher loss ratio, as well as to an increase in actuarial reserves.  The loss ratio for the period increased 120 basis points to 56.3% in 2016.
Underwriting and Other Expenses

Underwriting and other expenses increased by $2.1 million, or 4.0%, primarily reflecting an increase in commissions expense following the segment’s premium growth during these period.  In addition, the segment has incurred in higher development and marketing expenses related to the developmentexpansion of the Costa Rica operations.  TheAs a result, the segment’s operating expense ratio decreased 110increased to 46.9%, 90 basis points to 46.9% in 2016, reflecting the increase in premiums during the periodpoints..
 
Property and Casualty Insurance Operating Results

 
Three months ended
September 30,
  
Nine months ended
September 30,
  
Three months ended
March 31,
 
(Dollar amounts in millions) 2016  2015  2016  2015 
(dollar amounts in millions) 2017  2016 
Operating revenues:                  
Premiums earned, net:                  
Premiums written $32.4  $32.3  $100.9  $99.3  $27.4  $27.6 
Premiums ceded  (11.8)  (12.0)  (35.3)  (35.3)  (10.1)  (10.4)
Change in unearned premiums  1.4   1.4   (0.6)  3.0   4.4   4.1 
Premiums earned, net  22.0   21.7   65.0   67.0   21.7   21.3 
Net investment income  2.3   2.0   6.6   6.1   1.9   1.9 
Total operating revenues  24.3   23.7   71.6   73.1   23.6   23.2 
Operating costs:                        
Claims incurred  9.4   10.3   30.0   32.9   10.6   9.7 
Underwriting and other expenses  10.9   10.8   32.1   33.6   10.9   11.4 
Total operating costs  20.3   21.1   62.1   66.5   21.5   21.1 
Operating income $4.0  $2.6  $9.5  $6.6  $2.1  $2.1 
Additional data:                        
Loss ratio  42.7%  47.5%  46.2%  49.1%  48.8%  45.5%
Operating expense ratio  49.5%  49.8%  49.4%  50.1%  50.2%  53.5%
Combined ratio  92.2%  97.3%  95.6%  99.2%

Three Months Ended September 30, 2016March 31, 2017 Compared to Three Months Ended September 30, 2015March 31, 2016

Operating Revenues

Total premiums written increaseddecreased by $0.1$0.2 million, or 0.3%0.7%, to $32.4$27.4 million, mostly resulting from higherdriven by lower sales of Commercial Auto insurance products, offset by lower sales in the Commercial Package insurancepackage products.

The premiums ceded to reinsurers decreased by $0.2$0.3 million, or 1.7%2.9%, mostly reflecting favorable pricinglower premiums written in Commercial insurance products.
The change in unearned premiums presents an increase of $0.3 million mostly reflecting the market for nonproportional reinsurance treaties.segments lower premiums written in 2017 and lower cost.

Claims Incurred

Claims incurred decreasedincreased by $0.9 million, or 8.7%9.3%, to $9.4$10.6 million.  The loss ratio decreased 480increased by 330 basis points, to 42.7%,48.8% during this period, primarily as a result of favorablean unfavorable loss experience in the Medical Malpractice lineCommercial and Personal Auto lines of business.

Underwriting and Other Expenses

Underwriting and other operating expenses increased by $0.1 million, or 0.9%, mostly due to the timing of the receipt of a refund distribution from the Joint Underwriting Association (JUA), which was received during the second quarter in 2016 and during the third quarter in 2015.
Nine Months Ended September 30, 2016 Compared to Nine Months Ended September 30, 2015

Operating Revenues

Total premiums written increased by $1.6 million, or 1.6%, to $100.9 million, mostly reflecting higher sales of the Compulsory Vehicle Liability and Commercial Package insurance product.

The change in unearned premiums presents a decrease of $3.6 million mostly reflecting the segment’s higher volume of premiums written in 2016.

Claims Incurred

Claims incurred decreased by $2.9 million, or 8.8%, to $30.0 million. The loss ratio decreased by 290 basis points, to 46.2% during this period, mostly reflecting a favorable loss experience in the Commercial Auto line of business.

Underwriting and Other Expenses

Underwriting and other operating expenses decreased by $1.5$0.5 million, or 4.5%4.4%, to $32.1$10.9 million mostly due to lower net commission expenses driven by a decrease in net premiums earnedpersonnel 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:

 
Nine months ended
September 30,
  
Three months ended
March 31,
 
(dollar amounts in millions) 2016  2015  2017  2016 
Sources (uses) of cash:            
Cash provided by operating activities $83.0  $171.5  $131.0  $31.3 
Net purchases of investment securities  (86.6)  (17.6)
Net proceeds (purchases) of investment securities  0.4   (108.9)
Net capital expenditures  (3.5)  (5.6)  (3.3)  (1.5)
Proceeds from long-term borrowings  24.3   - 
Payments of long-term borrowings  (1.2)  (12.2)  (24.7)  (0.4)
Proceeds from policyholder deposits  12.5   5.6   4.1   3.4 
Surrenders of policyholder deposits  (13.5)  (10.5)  (4.9)  (2.9)
Repurchase and retirement of common stock  (21.4)  (41.0)  -   (8.0)
Other  (1.6)  (5.8)  (11.4)  1.6 
Net (decrease) increase in cash and cash equivalents $(32.3) $84.4 
Net increase (decrease) in cash and cash equivalents $115.5  $(85.4)

Cash flow from operating activities decreasedincreased by $99.7 million for the three months ended March 31, 2017 as a resultcompared to the three months ended March 31, 2016, principally due to an increase in premium collections of higher$67.1 million, lower claims paid by $240.4$16.5 million and an increasea decrease in cash paid to suppliers and employees by $25.0 million, offset in part by an increase inof $14.4 million.   The higher premium collections of $165.8 million.  The increasefollow the collection in claims paid and premiums collected is principally the resultadvance of the change inApril 2017 Medicare premiums from CMS.
Net proceeds from sales of investments securities primarily results from net cash flows received from the Medicaid delivery model from an ASO agreement to a fully insured model effective April 1, 2015.

Increase in netsales, maturities, and purchases of investments ininvestment securities are part ofduring the period following our asset/liability management strategy using cash on hand.strategy.

Payments of long-term borrowings decreased by $11.0During 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 nine2017 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 September 30, 2016, primarily dueMarch 31, 2017.
The fluctuation in the Other uses/sources of cash is attributed to an $11.0 million repaymentchanges in the amount of certain senior unsecured notes principal during the 2015 period.

In November 2015 the Company’s Board of Directors authorized a $25.0 million repurchase program of our Class B common stock. Repurchases were conducted through open-market purchases of Class B shares only, in accordance with Rule 10b-18 under the Securities Exchange Act of 1934, as amended.  During the nine months ended September 30, 2016, the Company repurchased and retired 951,831 shares of our Class B Common Stock at an average per share price of $22.54, for an aggregate cost of $21.4 million.  This program was completed on September 14, 2016.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 September 30, 2016,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 September 30, 2016.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 October 1, 2010 and May 14, 2015 we repaid $25.0December 28, 2016, TSM entered into a $35.5 million and $11.0 million, respectively, of the principal of these senior unsecured notes.  Amount currently outstanding is $24.0 million.  The 6.6% notes contain certain non-financial covenants with which we are in compliance at September 30, 2016.

In addition, we are a party to a secured term loancredit agreement with a commercial bank in Puerto Rico. ThisThe 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 originalthe 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 balanceamount plus accrued interest of $41.0 million, bears interest at a rate equalthe 6.6% senior unsecured notes due January 2021 ($24.0 million).  Pursuant to the London Interbank Offered Rate (LIBOR) plus 100 basis points and requires monthly principal repayments of $0.1 million.  As of September 30, 2016, this secured loan had ancredit agreement, interest is payable on the outstanding balance of $11.6 millionthe Loan at the following annual rate: (i) 1% over LIBOR for Term Loan A, (ii) 2.75% over LIBOR for Term Loan B, and average annual interest rate of 1.44%.  This secured(iii) 3.25% over LIBOR for Term Loan C.  The loan is guaranteed by a first lien on our land, buildingsincludes certain financial and substantially all leasehold improvements, as collateral for the term of the agreements under a continuing general security agreement.  This secured loan contains certain non-financial covenants, thatwhich 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.  As of September 30, 2016 we are in compliance with these covenants.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 November 4, 2015, March 11, 2016 TSS entered into a $50.0$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 25025 basis points, matures on November 4, 2016, and contains certain financial and non-financial covenants that are customary for this type of facility. The agreement stipulates that any unused balance would become unavailable should TSS stop collecting payments under the Medicaid contract for four consecutive weeks.

On March 11, 2016, TSS entered into a $30.0 million revolving loan agreement with a commercial bank in Puerto Rico. This line of credit, unused as of June 30, 2016, has an interest rate of LIBOR plus 220 basis points, matures on March 11, 2017, 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, 2015.2016.
 
Critical Accounting Estimates – Goodwill and Other Intangible Asset40


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, 2015.2016.  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, 2015.

In 2016 we have increased our market risk exposure to equity instruments to include certain mutual funds, whose underlying assets are mostly comprised of US and international common equities, preferred equity, debt instruments and loan participations, and private investments.  We hold these positions in our available-for-sale portfolio.  The mutual funds invest primarily in equity and debt securities issued or guaranteed by corporations and financial institutions that are either unrated or have non-investment grade ratings from either Standard & Poor’s or Moody’s. The private investments are comprised of private equity style closed end funds, which make direct equity and debt investments.  Our additional investments increase our exposure to equity price risk and credit risk.  We manage this indirect exposure to credit risk by closely monitoring the performance of these mutual funds.  Assuming an immediate decrease of 10% in the market value of our investments in equity securities as of September 30, 2016 and December 31, 2015, the hypothetical loss in the fair value of these investments would have been approximately $30.2 million and $19.7 million, respectively.  See note 3 to consolidated financial statements included in Item 1 of this Quarterly Report on Form 10-Q.2016.
 
Item 4.
Controls and Procedures

Evaluation of Disclosure Controls and Procedures

BasedIn connection with the preparation of this Quarterly Report on an evaluation of the effectiveness of the Corporation’s disclosure controls and procedures conductedForm 10-Q, management, under the supervision and with the participation of management, the chief executive officer (CEO) and the chief financial officer, (CFO) concluded that, as of September 30, 2016, which is the endconducted an evaluation of the period covered by this Quarterly Report on Form 10-Q, our disclosureeffectiveness 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 effectivedesigned to ensure that information required to be disclosed by the Corporation in the report that it filesreports filed or submitssubmitted 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 CEOchief executive officer and CFO, as appropriatechief 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 CEOchief executive officer and CFOchief 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 September 30, 2016March 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 1413 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, 2015.2016.
 
43The 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

Purchases of Equity Securities by the IssuerNot applicable.
The following table presents information related to our repurchases of common stock for the period indicated:

(Dollar amounts in millions, except per share data) 
Total Number
of Shares
Purchased
  
Average
Price
Paid per
Share
  
Total Number of
Shares
Purchased as
Part of Publicly
Announced
Programs ¹
  
Approximate
Dollar Value of
Shares that May
Yet Be Purchased
Under the
Programs
 
             
July 1, 2016 to July 31, 2016  -  $-   -  $6.8 
August 1, 2016 to August 31, 2016  174,500   22.93   174,500   2.8 
September 1, 2016 to September 30, 2016  125,384   22.31   125,384   - 

¹  In November 2015 the Company's Board of Directors authorized a $25.0 million Share Repurchase Program of its Class B common stock.  This program was completed on September 14, 2016.

Item 3.
Defaults Upon Senior Securities

Not applicable.

Item 4.
Mine Safety Disclosures

Not applicable.

Item 5.
Other Information

Not applicable.

Item 6.
Exhibits

ExhibitsDescription
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.
  
11Statement re computation of per share earnings; an exhibit describing the computation of the earnings per share for the three and nine months ended September 30,March 31, 2017 and 2016 and 2015 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:November 4, 2016May 9, 2017 By:/s/ Roberto García-Rodríguez 
    Roberto García-Rodríguez 
    President and Chief Executive Officer
      
Date:November 4, 2016May 9, 2017 By:/s/ Juan J. Román-Jiménez 
    Juan J. Román-Jiménez 
    Executive Vice President and Chief Financial Officer
 
 
4543