Triple-s Management (GTS) 10-Q 4 Nov 21 2021 Q3 Quarterly report Financial data

Document and Entity Information

Document and Entity Information	9 Months Ended
	Sep. 30, 2021shares
Cover [Abstract]
Document Type	10-Q
Amendment Flag	false
Document Quarterly Report	true
Document Period End Date	Sep. 30, 2021
Current Fiscal Year End Date	--12-31
Document Fiscal Year Focus	2021
Document Fiscal Period Focus	Q3
Document Transition Report	false
Entity File Number	001-33865
Entity Registrant Name	TRIPLE-S MANAGEMENT CORPORATION
Entity Central Index Key	0001171662
Entity Incorporation, State or Country Code	PR
Entity Tax Identification Number	66-0555678
Entity Address, Address Line One	1441 F.D. Roosevelt Avenue
Entity Address, City or Town	San Juan
Entity Address, Country	PR
Entity Address, Postal Zip Code	00920
City Area Code	787
Local Phone Number	749-4949
Title of 12(b) Security	Common Stock, $1.00 par value
Trading Symbol	GTS
Security Exchange Name	NYSE
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Accelerated Filer
Entity Small Business	false
Entity Emerging Growth Company	false
Entity Shell Company	false
Entity Common Stock, Shares Outstanding	23,794,612

Condensed Consolidated Interim

Condensed Consolidated Interim Balance Sheets (Unaudited) - USD ($) $ in Thousands	Sep. 30, 2021	Dec. 31, 2020
Investments and cash:
Fixed-maturities available-for-sale, at fair value	$ 1,290,234	$ 1,342,465
Fixed-maturities held-to-maturity, at amortized cost	1,870	1,867
Equity investments, at fair value	518,765	404,328
Other invested assets, at net asset value	119,396	114,905
Policy loans	10,480	10,459
Cash and cash equivalents	122,709	110,989
Total investments and cash	2,063,454	1,985,013
Premiums and other receivables, net	496,477	488,840
Deferred policy acquisition costs and value of business acquired	255,010	248,325
Property and equipment, net	137,762	131,974
Deferred tax asset	111,206	119,534
Goodwill	28,614	28,614
Other assets	99,143	86,118
Total assets	3,191,666	3,088,418
Liabilities and Stockholders' Equity
Claim liabilities	798,508	787,102
Liability for future policy benefits	438,008	414,997
Unearned premiums	101,331	97,481
Policyholder deposits	214,912	206,109
Liability to Federal Employees' Health Benefits and Federal Employees' Programs	35,358	45,109
Accounts payable and accrued liabilities	389,918	332,699
Deferred tax liability	13,533	15,046
Short-term borrowings	0	30,000
Long-term borrowings	49,498	52,751
Liability for pension benefits	133,659	139,611
Total liabilities	2,174,725	2,120,905
Triple-S Management Corporation stockholders' equity
Common stock, $1 par value. Authorized 100,000,000 shares; issued and outstanding 23,794,612 and 23,430,292 shares at September 30, 2021 and December 31, 2020, respectively	23,795	23,430
Additional paid-in capital	63,471	57,399
Retained earnings	952,258	897,221
Accumulated other comprehensive loss, net	(21,850)	(9,820)
Total Triple-S Management Corporation stockholders' equity	1,017,674	968,230
Non-controlling interest in consolidated subsidiary	(733)	(717)
Total stockholders' equity	1,016,941	967,513
Total liabilities and stockholders' equity	$ 3,191,666	$ 3,088,418

Condensed Consolidated Interi_2

Condensed Consolidated Interim Balance Sheets (Unaudited) (Parenthetical) - $ / shares	Sep. 30, 2021	Dec. 31, 2020
Triple-S Management Corporation stockholders' equity
Common stock, par value (in dollars per share)	$ 1	$ 1
Common stock, authorized (in shares)	100,000,000	100,000,000
Common stock, issued (in shares)	23,794,612	23,430,292
Common stock, outstanding (in shares)	23,794,612	23,430,292

Condensed Consolidated Interi_3

Condensed Consolidated Interim Statements of Earnings (Unaudited) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Revenues
Premiums earned, net	$ 1,019,696	$ 922,934	$ 3,016,012	$ 2,657,366
Administrative service fees	3,875	3,752	9,316	8,755
Net investment income	17,572	14,168	46,178	42,294
Other operating revenues	3,925	2,052	8,518	6,394
Total operating revenues	1,045,068	942,906	3,080,024	2,714,809
Net realized investment gains (losses)	1,015	507	3,746	(180)
Net unrealized investment (losses) gains on equity investments	(7,912)	11,040	13,383	(17,428)
Other income, net	11,085	1,811	19,047	6,217
Total revenues	1,049,256	956,264	3,116,200	2,703,418
Benefits and expenses
Claims incurred, net of reinsurance	878,947	761,792	2,573,569	2,129,401
Operating expenses	154,526	158,809	456,880	499,669
Total operating costs	1,033,473	920,601	3,030,449	2,629,070
Interest expense	2,016	2,096	6,225	5,813
Total benefits and expenses	1,035,489	922,697	3,036,674	2,634,883
Income before taxes	13,767	33,567	79,526	68,535
Income tax expense	5,607	9,989	24,505	27,520
Net income	8,160	23,578	55,021	41,015
Net loss attributable to non-controlling interest	7	3	16	20
Net income attributable to Triple-S Management Corporation	$ 8,167	$ 23,581	$ 55,037	$ 41,035
Earnings per share attributable to Triple-S Management Corporation
Basic net income per share (in dollars per share)	$ 0.35	$ 1.02	$ 2.35	$ 1.77
Diluted net income per share (in dollars per share)	$ 0.35	$ 1.02	$ 2.34	$ 1.76

Condensed Consolidated Interi_4

Condensed Consolidated Interim Statements of Comprehensive Income (Loss) (Unaudited) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Condensed Consolidated Interim Statements of Comprehensive Income (Loss) (Unaudited) [Abstract]
Net income	$ 8,160	$ 23,578	$ 55,021	$ 41,015
Other comprehensive income (loss), net of tax:
Net unrealized change in fair value of available-for-sale securities, net of taxes	421	4,743	(13,869)	32,023
Defined benefit pension plan:
Actuarial loss, net	621	247	1,839	553
Total other comprehensive income (loss), net of tax	1,042	4,990	(12,030)	32,576
Comprehensive income	9,202	28,568	42,991	73,591
Comprehensive loss attributable to non-controlling interest	7	3	16	20
Comprehensive income attributable to Triple-S Management Corporation	$ 9,209	$ 28,571	$ 43,007	$ 73,611

Condensed Consolidated Interi_5

Condensed Consolidated Interim Statements of Stockholders' Equity (Unaudited) - USD ($) $ in Thousands	Common Stock [Member]Class A Common Stock [Member]	Common Stock [Member]Class B Common Stock [Member]	Additional Paid-in Capital [Member]	Retained Earnings [Member]	Accumulated Other Comprehensive (Loss) Income [Member]	Triple-S Management Corporation [Member]	Noncontrolling Interest in Consolidated Subsidiary [Member]	Total	Cumulative Effect, Period of Adoption, Adjustment [Member]Common Stock [Member]Class A Common Stock [Member]	Cumulative Effect, Period of Adoption, Adjustment [Member]Common Stock [Member]Class B Common Stock [Member]	Cumulative Effect, Period of Adoption, Adjustment [Member]Additional Paid-in Capital [Member]	Cumulative Effect, Period of Adoption, Adjustment [Member]Retained Earnings [Member]	Cumulative Effect, Period of Adoption, Adjustment [Member]Accumulated Other Comprehensive (Loss) Income [Member]	Cumulative Effect, Period of Adoption, Adjustment [Member]Triple-S Management Corporation [Member]	Cumulative Effect, Period of Adoption, Adjustment [Member]Noncontrolling Interest in Consolidated Subsidiary [Member]	Cumulative Effect, Period of Adoption, Adjustment [Member]
Balance at Dec. 31, 2019	$ 0	$ 23,800	$ 60,504	$ 830,198	$ 29,363	$ 943,865	$ (693)	$ 943,172
Balance (ASU 2016-13 [Member]) at Dec. 31, 2019									$ 0	$ 0	$ 0	$ (166)	$ 0	$ (166)	$ 0	$ (166)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Share-based compensation	0	590	1,769	0	0	2,359	0	2,359
Repurchase and retirement of common stock	0	(584)	(8,511)	0	0	(9,095)	0	(9,095)
Comprehensive income (loss)	0	0	0	(26,145)	16,032	(10,113)	(7)	(10,120)
Balance at Mar. 31, 2020	0	23,806	53,762	803,887	45,395	926,850	(700)	926,150
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Share-based compensation	0	7	4,228	0	0	4,235	0	4,235
Repurchase and retirement of common stock	0	(375)	(5,618)	0	0	(5,993)	0	(5,993)
Comprehensive income (loss)	0	0	0	43,599	11,554	55,153	(10)	55,143
Balance at Jun. 30, 2020	0	23,438	52,372	847,486	56,949	980,245	(710)	979,535
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Share-based compensation	0	7	1,842	0	0	1,849	0	1,849
Repurchase and retirement of common stock	0	(15)	(250)	0	0	(265)	0	(265)
Comprehensive income (loss)	0	0	0	23,581	4,990	28,571	(3)	28,568
Balance at Sep. 30, 2020	0	23,430	53,964	871,067	61,939	1,010,400	(713)	1,009,687
Balance at Dec. 31, 2020	0	23,430	57,399	897,221	(9,820)	968,230	(717)	967,513
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Share-based compensation	0	250	932	0	0	1,182	0	1,182
Comprehensive income (loss)	0	0	0	23,310	(15,944)	7,366	(3)	7,363
Balance at Mar. 31, 2021	0	23,680	58,331	920,531	(25,764)	976,778	(720)	976,058
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Share-based compensation	0	137	2,614	0	0	2,751	0	2,751
Repurchase and retirement of common stock	0	(21)	(461)	0	0	(482)	0	(482)
Comprehensive income (loss)	0	0	0	23,560	2,872	26,432	(6)	26,426
Balance at Jun. 30, 2021	0	23,796	60,484	944,091	(22,892)	1,005,479	(726)	1,004,753
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Share-based compensation	0	1	3,030	0	0	3,031	0	3,031
Repurchase and retirement of common stock	0	(2)	(43)	0	0	(45)	0	(45)
Comprehensive income (loss)	0	0	0	8,167	1,042	9,209	(7)	9,202
Balance at Sep. 30, 2021	$ 0	$ 23,795	$ 63,471	$ 952,258	$ (21,850)	$ 1,017,674	$ (733)	$ 1,016,941

Condensed Consolidated Interi_6

Condensed Consolidated Interim Statements of Cash Flows (Unaudited) - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020
Cash flows from operating activities:
Net income	$ 55,021	$ 41,015
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization	10,667	10,855
Net amortization of investments	2,290	2,151
(Reversal) provision for doubtful receivables	(340)	2,229
Deferred tax expense	8,635	2,277
Net realized investment (gains) losses on sale of securities	(3,746)	180
Net unrealized (gains) losses on equity investments	(13,383)	17,428
Interest credited to policyholder deposits	4,874	4,788
Share-based compensation	6,964	8,443
Gain on sale of property and equipment	0	154
(Increase) decrease in assets:
Premium and other receivables, net	(7,811)	26,038
Deferred policy acquisition costs and value of business acquired	(5,474)	(10,827)
Deferred taxes	45	(109)
Other assets	(11,197)	(29,831)
Increase (decrease) in liabilities:
Claim liabilities	11,406	77,662
Liability for future policy benefits	23,011	22,099
Unearned premiums	3,850	2,307
Liability to Federal Employees' Health Benefits and Federal Employees' Programs	(9,751)	10,093
Accounts payable and accrued liabilities	25,638	36,729
Net cash provided by operating activities	100,699	223,681
Securities available for sale:
Fixed-maturities sold	140,866	94,557
Fixed-maturities matured/called	18,271	37,450
Securities held to maturity:
Fixed-maturities matured/called	747	1,079
Equity investments sold	99,951	80,152
Other invested assets sold	19,652	13,231
Securities available for sale:
Fixed-maturities	(129,066)	(206,387)
Securities held to maturity:
Fixed-maturities	(751)	(1,087)
Equity investments	(199,046)	(201,324)
Other invested assets	(9,317)	(25,442)
Increase in other investments	(4,470)	(3,924)
Net change in policy loans	(21)	240
Net capital expenditures	(16,948)	(52,549)
Capital contribution on equity method investees	0	(7,083)
Net cash used in investing activities	(80,132)	(271,087)
Cash flows from financing activities:
Change in outstanding checks in excess of bank balances	20,594	16,814
Net change in short-term borrowings	(30,000)	28,500
Proceeds from long-term borrowings	0	30,841
Repayments of long-term borrowings	(3,370)	(2,760)
Repurchase and retirement of common stock	0	(14,980)
Proceeds from policyholder deposits	12,594	21,586
Surrenders of policyholder deposits	(8,665)	(12,829)
Net cash (used in) provided by financing activities	(8,847)	67,172
Net increase in cash and cash equivalents	11,720	19,766
Cash and cash equivalents:
Beginning of period	110,989	109,837
End of period	$ 122,709	$ 129,603

Basis of Presentation

Basis of Presentation	9 Months Ended
	Sep. 30, 2021
Basis of Presentation [Abstract]
Basis of Presentation	1. Basis of Presentation The accompanying condensed consolidated interim financial statements prepared by Triple-S Management Corporation (Triple-S, TSM, the Company, the Corporation, we, us or our) and its subsidiaries are unaudited. The condensed consolidated interim financial statements do not include all the information and the footnotes required by accounting principles generally accepted in the United States of America (GAAP or U.S. GAAP) for complete financial statement presentation pursuant to the rules and regulations of the Securities and Exchange Commission (SEC). Accordingly, these condensed consolidated interim financial statements should be read in conjunction with the audited consolidated financial statements included in the Company’s Annual Report on Form 10-K for the year ended December 31, 2020. 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 and nine months ended September 30, 2021 are not necessarily indicative of the results for the full year ending December 31, 2021.

Significant Accounting Policies

Significant Accounting Policies	9 Months Ended
	Sep. 30, 2021
Significant Accounting Policies [Abstract]
Significant Accounting Policies	2. Significant Accounting Policies Recently Adopted Accounting Standards On August 28, 2018, the Financial Accounting Standards Board (FASB) issued guidance for Compensation – Retirement Benefits – Defined Benefit Plans – General which addresses changes to the disclosure requirement for defined benefit plans. The amendments in this guidance modify the disclosure requirements for employers that sponsor defined benefit pension or other postretirement plans. Specifically, the guidance removes certain disclosure requirements, including the amounts of accumulated other comprehensive income expected to be recognized as components of net periodic benefit cost over the next fiscal year, related-party disclosures concerning the amount of future annual benefits covered by insurance and annuity contracts and significant transactions between the employer and related-parties and the plan, and adds other disclosures including the weighted-average interest crediting rates for cash balance plans and other plans with promised interest crediting rates, and an explanation for the reasons for significant gains and losses related to changes in the benefit obligation for the period. The Company adopted the standard effective January 1, 2021. The adoption of this guidance did not have a material impact on the presentation and disclosures of the Company’s consolidated financial statements. On December 18, 2019, the FASB issued Accounting Standards Update (ASU) 2019-12: Income Taxes (Topic 740): Simplifying the Accounting for Income Taxes. The amendments in this update simplify the accounting for income taxes by removing certain exceptions to the general principles in Topic 740. Also, the amendments simplify the accounting for income taxes by requiring the following: (1) that an entity recognize a franchise tax that is partially based on income in accordance with Topic 740 and account for any incremental amount incurred as a non-income-based tax; (2) that an entity evaluate when a step-up in the tax basis of Goodwill should be considered part of the business combination in which the book goodwill was originally recognized and when it should instead be considered a separate transaction; and (3) that an entity reflect the effect of an enacted change in tax laws or rates in the annual effective tax rate computation in the interim period that included the enactment date. The Company adopted the standard effective January 1, 2021. The adoption of this guidance did not have a material impact on the results of the Company’s consolidated financial statements. On January 16, 2020, the FASB issued guidance to clarify the interaction between the accounting standards on recognition and measurement of financial instruments in Topic 321: Investments – Equity Securities, the one on equity method investments in Topic 323: Investments – Equity Method and Joint Ventures, and forward contracts and purchased options in Topic 815: Derivatives and Hedging. The amendments clarify that upon an increase or decrease in level of ownership or degree of influence, a company should remeasure the interest held in the investee to take into account observable transactions immediately before applying or discontinuing the equity method of accounting under Topic 323. The guidance also clarifies that an entity should not consider whether, upon the settlement of the forward contract or exercise of the purchase option, individually or with existing investments, the underlying securities would be accounted for under the equity method in Topic 323 or the fair value option. The Company adopted the standard effective January 1, 2021. The adoption of this guidance did not have a material impact on the results of the Company’s consolidated financial statements. Future Adoptions of Accounting Standards On January 7, 2021, the FASB issued ASU 2021-01: Reference Rate Reform (Topic 848): Scope Refinement – to clarify the scope of the recent reference reform guidance in Topic 848. This ASU refines the scope of Topic 848 and clarifies that certain optional expedients and exceptions therein for contract modifications and hedge accounting apply to contracts that are affected by the discounting transition. Specifically, modifications related to reference rate reform would not be considered an event that requires reassessment of previous accounting conclusions. The ASU also amends the expedients and exceptions in Topic 848 to capture the incremental consequences of the scope clarification and to tailor the existing guidance to derivative instruments affected by the discounting transition. The amendments in the ASU are effective immediately for all entities. The Company is currently in the process of identifying its LIBOR-based contracts that will be affected by the phase-out of LIBOR and expects to use the optional expedients provided in this ASU. Other than the accounting pronouncements disclosed above, there were no other new accounting pronouncements issued during the three and nine months ended September 30, 2021 that could have a material impact on the Company’s financial position, operating results or financials statement disclosures.

Investment in Securities

Investment in Securities	9 Months Ended
	Sep. 30, 2021
Investment in Securities [Abstract]
Investment in Securities	3. Investment in Securities The amortized cost for debt securities and alternative investments, gross unrealized gains and losses, and estimated fair value for the Company’s investments in securities by major security type and class of security as of September 30, 2021, and December 31, 2020, were as follows: September 30, 2021 Amortized cost Gross unrealized gains Gross unrealized losses Estimated fair value Fixed-maturities available-for-sale Obligations of government-sponsored enterprises $ 21,303 $ 294 $ (53 ) $ 21,544 U.S. Treasury securities and obligations of U.S. government instrumentalities 104,546 5,367 (4 ) 109,909 Municipal securities 611,211 40,598 (853 ) 650,956 Corporate bonds 177,640 23,510 (69 ) 201,081 Residential mortgage-backed securities 284,745 16,807 (546 ) 301,006 Collateralized mortgage obligations 5,301 437 - 5,738 Total fixed-maturities available-for-sale $ 1,204,746 $ 87,013 $ (1,525 ) $ 1,290,234 December 31, 2020 Amortized cost Gross unrealized gains Gross unrealized losses Estimated fair value Fixed-maturities available-for-sale Obligations of government-sponsored enterprises $ 24,496 $ 665 $ (9 ) $ 25,152 U.S. Treasury securities and obligations of U.S. government instrumentalities 103,694 7,993 - 111,687 Municipal securities 646,961 54,067 - 701,028 Corporate bonds 189,516 30,280 - 219,796 Residential mortgage-backed securities 249,801 21,487 (57 ) 271,231 Collateralized mortgage obligations 12,954 638 (21 ) 13,571 Total fixed-maturities available-for-sale $ 1,227,422 $ 115,130 $ (87 ) $ 1,342,465 September 30, 2021 Amortized cost Gross unrealized gains Gross unrealized losses Estimated fair value Fixed-maturities held-to-maturity U.S. Treasury securities and obligations of U.S. government instrumentalities $ 613 $ 154 $ - $ 767 Residential mortgage-backed securities 164 8 - 172 Certificates of deposit 1,093 - - 1,093 Total fixed-maturities held-to-maturity $ 1,870 $ 162 $ - $ 2,032 December 31, 2020 Amortized cost Gross unrealized gains Gross unrealized losses Estimated fair value Fixed-maturities held-to-maturity U.S. Treasury securities and obligations of U.S. government instrumentalities $ 614 $ 201 $ - $ 815 Residential mortgage-backed securities 164 17 - 181 Certificates of deposit 1,089 - - 1,089 Total fixed-maturities held-to-maturity $ 1,867 $ 218 $ - $ 2,085 September 30, 2021 Amortized cost Gross unrealized gains Gross unrealized losses Estimated fair value Other invested assets - Alternative investments $ 105,151 $ 17,908 $ (3,663 ) $ 119,396 December 31, 2020 Amortized cost Gross unrealized gains Gross unrealized losses Estimated fair value Other invested assets - Alternative investments $ 112,171 $ 6,119 $ (3,385 ) $ 114,905 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, 2021 and December 31, 2020 were as follows: September 30, 2021 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 Fixed-maturities available-for-sale Obligations of government-sponsored enterprises $ 4,665 $ (22 ) 4 $ 1,518 $ (31 ) 1 $ 6,183 $ (53 ) 5 U.S. Treasury securities and obligations of U.S. government instrumentalities 983 (4 ) 1 - - - 983 (4 ) 1 Municipal securities 70,535 (853 ) 16 - - - 70,535 (853 ) 16 Corporate bonds 3,931 (69 ) 1 - - - 3,931 (69 ) 1 Residential mortgage-backed securities 48,592 (546 ) 13 - - - 48,592 (546 ) 13 Total fixed-maturities available-for-sale $ 128,706 $ (1,494 ) 35 $ 1,518 $ (31 ) 1 $ 130,224 $ (1,525 ) 36 Other invested assets - Alternative investments $ 2,439 $ (105 ) 2 $ 18,022 $ (3,558 ) 7 $ 20,461 $ (3,663 ) 9 December 31, 2020 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 Fixed-maturities available-for-sale Obligations of government-sponsored enterprises $ 1,539 $ (9 ) 1 $ - $ - - $ 1,539 $ (9 ) 1 Residential mortgage-backed securities 3,624 (57 ) 1 - - - 3,624 (57 ) 1 Collateralized mortgage obligations 6,060 (21 ) 2 - - - 6,060 (21 ) 2 Total fixed-maturities available-for-sale $ 11,223 $ (87 ) 4 $ - $ - - $ 11,223 $ (87 ) 4 Other invested assets - Alternative investments $ 12,584 $ (808 ) 4 $ 16,396 $ (2,577 ) 6 $ 28,980 $ (3,385 ) 10 The Company reviews the available-for-sale and other invested assets portfolios under the Company’s impairment review policy. Given market conditions and the significant judgments involved, there is a continuing risk that declines in fair value may occur and material allowances for credit losses may be recorded in future periods. The Company from time to time may sell investments as part of its asset/liability management process or to reposition its investment portfolio based on current and expected market conditions. • Obligations of government-sponsored enterprises, U.S. treasury securities and obligations of U.S government instrumentalities, and Municipal securities: The unrealized losses of these securities were mainly caused by fluctuations in interest rates and general market conditions. The contractual terms of these investments do not permit the issuer to settle the securities at a price less than the par value of the investment. In addition, they have investment-grade ratings. The Company does not consider these investments to be credit-impaired because of several factors: the decline in fair value is attributable to changes in interest rates and not credit quality; 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 at maturity; and because the Company expects to collect all contractual cash flows. • Corporate bonds: The unrealized losses of these bonds were mainly caused by fluctuations in interest rates and general market conditions. All corporate bonds with an unrealized loss have investment grade ratings. The Company does not consider these investments to be credit-impaired because of several factors: the decline in fair value is attributable to changes in interest rates and not credit quality; 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 at maturity; and because the Company expects to collect all contractual cash flows. • Residential mortgage-backed securities: The unrealized losses on these investments were mostly caused by fluctuations in interest rates and credit spreads. The contractual cash flows of these securities 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, 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 Company owns. The Company does not consider these investments to be credit-impaired because of several factors: the decline in fair value is attributable to changes in interest rates and not credit quality; the Company does not intend to sell the investments and it is more likely than not that the Company will not be required to sell the investments before recovery of their amortized cost basis, which may be at maturity; and because the Company expects to collect all contractual cash flows. • Alternative Investments: As of September 30, 2021, alternative investments with unrealized losses were not considered credit-impaired based on market conditions. Maturities of investment securities classified as available-for-sale and held-to-maturity were as follows: September 30, 2021 Amortized cost Estimated fair value Fixed-maturities available-for-sale Due in one year or less $ 60,380 $ 61,218 Due after one year through five years 572,854 605,722 Due after five years through ten years 149,432 157,360 Due after ten years 132,034 159,190 Residential mortgage-backed securities 284,745 301,006 Collateralized mortgage obligations 5,301 5,738 $ 1,204,746 $ 1,290,234 Fixed-maturities held-to-maturity Due in one year or less $ 1,093 $ 1,093 Due after ten years 613 767 Residential mortgage-backed securities 164 172 $ 1,870 $ 2,032 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. On September 30, 2021 and December 31, 2020 investments with an amortized cost of $207,890 and $227,890 (fair value of $223,930 and $250,088), respectively, were pledged with the Federal Home Loan Bank of New York (FHLBNY) to secure short-term borrowings.

Realized and Unrealized Gains (

Realized and Unrealized Gains (Losses)	9 Months Ended
	Sep. 30, 2021
Realized and Unrealized Gains (Losses) [Abstract]
Realized and Unrealized Gains (Losses)	4. Realized and Unrealized Gains (Losses) Information regarding realized and unrealized gains and losses from investments is as follows: Three months ended Nine months ended September 30, September 30, 2021 2020 2021 2020 Realized gains (losses) Fixed-maturity securities Fixed-maturities available-for-sale Gross gains $ - $ 402 $ 90 $ 1,953 Gross losses (138 ) (1 ) (1,104 ) (7 ) Total fixed-maturity securities (138 ) 401 (1,014 ) 1,946 Equity investments Gross gains 238 67 2,121 1,057 Gross losses (19 ) (479 ) (438 ) (3,249 ) Gross losses from impaired securities - - - (678 ) Total equity investments 219 (412 ) 1,683 (2,870 ) Other invested assets Gross gains 934 518 3,077 744 Total other invested assets 934 518 3,077 744 Net realized gains (losses) on securities $ 1,015 $ 507 $ 3,746 $ (180 ) The gross losses from impaired securities during the nine months ended September 30, 2020 are Three months ended September 30, Nine months ended September 30, 2021 2020 2021 2020 Changes in net unrealized gains (losses): Recognized in accumulated other comprehensive income (loss): Fixed-maturities – available-for-sale $ (3,742 ) $ 4,705 $ (29,555 ) $ 44,943 Other invested assets 4,136 1,498 11,511 (2,700 ) $ 394 $ 6,203 $ (18,044 ) $ 42,243 Not recognized in the consolidated financial statements: Fixed-maturities – held-to-maturity $ (11 ) $ (6 ) $ (56 ) $ 64 The change in deferred tax asset (liability) on unrealized gains (losses) recognized in Accumulated Other Comprehensive Income nine months ended September 30, 2021 and 2020 $ and , respectively. As of September 30, 2021 and December 31, 2020, no individual investment in securities exceeded 10% of stockholders’ equity.

Premiums and Other Receivables,

Premiums and Other Receivables, Net	9 Months Ended
	Sep. 30, 2021
Premiums and Other Receivables, Net [Abstract]
Premiums and Other Receivables, Net	5. Premiums and Other Receivables, Net Premiums and Other Receivables, Net were as follows: September 30, 2021 December 31, 2020 Premiums $ 177,298 $ 106,322 Self-funded group receivables 27,767 26,412 FEHBP 15,002 12,830 Agent balances 30,235 31,509 Accrued interest 9,206 10,418 Reinsurance recoverable 157,665 216,314 Other 128,988 135,774 546,161 539,579 Less allowance for doubtful receivables: Premiums 34,433 37,231 Other 15,251 13,508 49,684 50,739 Total premium and other receivables, net $ 496,477 $ 488,840 As of September 30, 2021 and December 31, 2020, the Company had premiums and other receivables of $70,372 and $53,397, respectively, from the Government of Puerto Rico, including its agencies, municipalities and public corporations. The related allowance for doubtful receivables as of September 30, 2021 and December 31, 2020 were $20,164 and $23,752, respectively. Reinsurance recoverable as of September 30, 2021 and December 31, 2020 includes $115,160 and $172,021, respectively, related to catastrophe losses covered by the Property and Casualty segment’s reinsurance program.

Fair Value Measurements

Fair Value Measurements	9 Months Ended
	Sep. 30, 2021
Fair Value Measurements [Abstract]
Fair Value Measurements	6. Fair Value Measurements Our condensed Consolidated Balance Sheets include the following financial instruments: fixed-maturities available-for-sale, equity investments, policy loans, policyholder deposits, short-term borrowings and long-term borrowings. We consider the carrying amounts of policy loans, policyholder deposits, short-term borrowings and long-term borrowings to approximate their fair value and are considered Level 2 financial instruments. Certain assets are measured at fair value on a recurring basis and are disclosed below. These assets are classified into one of three levels of a hierarchy defined by GAAP. For a description of the methods and assumptions that are used to estimate the fair value and determine the fair value hierarchy classification of each class of financial instrument, see the consolidated financial statements and notes thereto included in our 2020 Annual Report on Form 10-K. The following tables summarize fair value measurements by level for assets measured at fair value on a recurring basis: September 30, 2021 Level 1 Level 2 Level 3 Total Fixed-maturities available-for-sale Obligations of government-sponsored enterprises $ - $ 21,544 $ - $ 21,544 U.S. Treasury securities and obligations of U.S. government instrumentalities 109,909 - - 109,909 Municipal securities - 650,956 - 650,956 Corporate bonds - 201,081 - 201,081 Residential agency mortgage-backed securities - 301,006 - 301,006 Collateralized mortgage obligations - 5,738 - 5,738 Total fixed-maturities available-for-sale $ 109,909 $ 1,180,325 $ - $ 1,290,234 Equity investments $ 276,531 $ 236,893 $ 5,341 $ 518,765 December 31, 2020 Level 1 Level 2 Level 3 Total Fixed-maturities available-for-sale Obligations of government-sponsored enterprises $ - $ 25,152 $ - $ 25,152 U.S. Treasury securities and obligations of U.S. government instrumentalities 111,687 - - 111,687 Municipal securities - 701,028 - 701,028 Corporate bonds - 219,796 - 219,796 Residential agency mortgage-backed securities - 271,231 - 271,231 Collateralized mortgage obligations - 13,571 - 13,571 Total fixed-maturities available-for-sale $ 111,687 $ 1,230,778 $ - $ 1,342,465 Equity investments $ 220,118 $ 179,108 $ 5,102 $ 404,328 The fair value of investment securities is estimated based on quoted market prices for those or similar investments. Additional information pertinent to the estimated fair value of investment in securities is included in Note 3. There were no transfers between Levels 1 and 2 during the three and nine months ended September 30, 2021 and the year ended December 31, 2020. 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 and nine months ended September 30 is as follows: Fair Value Measurements Using Significant Unobservable Inputs (Level 3) Three months ended Nine months ended September 30, 2021 September 30, 2021 Beginning Balance $ 5,199 $ 5,102 Unrealized in other accumulated comprehensive income 142 239 Ending Balance $ 5,341 $ 5,341

Claim Liabilities

Claim Liabilities	9 Months Ended
	Sep. 30, 2021
Claim Liabilities [Abstract]
Claim Liabilities	7. Claim Liabilities The tables below present a reconciliation of the beginning and ending balances of Claim Liabilities during the nine months ended September 30: Nine months ended September 30, 2021 Managed Care Other Business Segments * Consolidated Claim liabilities at beginning of period $ 445,655 $ 341,447 $ 787,102 Reinsurance recoverable on claim liabilities - (138,816 ) (138,816 ) Net claim liabilities at beginning of period 445,655 202,631 648,286 Claims incurred Current period insured events 2,485,095 92,526 2,577,621 Prior period insured events (35,986 ) 982 (35,004 ) Total 2,449,109 93,508 2,542,617 Payments of losses and loss-adjustment expenses Current period insured events 2,124,676 47,360 2,172,036 Prior period insured events 236,405 63,086 299,491 Total 2,361,081 110,446 2,471,527 Net claim liabilities at end of period 533,683 185,693 719,376 Reinsurance recoverable on claim liabilities - 79,132 79,132 Claim liabilities at end of period $ 533,683 $ 264,825 $ 798,508 * Other Business Segments include the Life Insurance and Property and Casualty segments, as well as intersegment eliminations. Nine months ended September 30, 2020 Managed Care Other Business Segments * Consolidated Claim liabilities at beginning of period $ 341,277 $ 367,981 $ 709,258 Reinsurance recoverable on claim liabilities - (137,017 ) (137,017 ) Net claim liabilities at beginning of period 341,277 230,964 572,241 Claims incurred Current period insured events 2,000,825 84,358 2,085,183 Prior period insured events 24,297 (7,885 ) 16,412 Total 2,025,122 76,473 2,101,595 Payments of losses and loss-adjustment expenses Current period insured events 1,678,400 45,815 1,724,215 Prior period insured events 267,427 41,081 308,508 Total 1,945,827 86,896 2,032,723 Net claim liabilities at end of period 420,572 220,541 641,113 Reinsurance recoverable on claim liabilities - 145,807 145,807 Claim liabilities at end of period $ 420,572 $ 366,348 $ 786,920 * Other Business Segments include the Life Insurance and Property and Casualty segments, as well as intersegment eliminations. The actual amounts of claims incurred in connection with insured events occurring in a prior period typically differ from estimates of such claims made in the prior period. Amounts included as incurred claims for prior period insured events reflect the aggregate net amount of these differences. The favorable developments in the claims incurred and loss-adjustment expenses for prior-period insured events for the nine months ended September 30, 2021 and 2020 were primarily due to better than expected utilization trends. Reinsurance recoverable on unpaid claims is reported as Premium and Other Receivables, Net in the accompanying condensed consolidated financial statements. The claims incurred disclosed in the table above exclude the portion of the change in the liability for future policy benefits amounting to during the three months and nine months ended September 30, 2021, respectively, and $ and $ during the three months and nine months ended September 30, 2020, respectively, which is included within the consolidated Claims Incurred. The following is information about incurred and paid claims development, net of reinsurance, as of September 30, 2021, as well as cumulative claim frequency. Additional information presented includes total incurred-but-not-reported liabilities plus expected development on reported claims which is included within the net incurred claims amounts. Incurred Year Total of IBNR Liabilities Plus Expected Development on Reported Claims 2020 $ 119,675 2021 360,419

Borrowings

Borrowings	9 Months Ended
	Sep. 30, 2021
Borrowings [Abstract]
Borrowings	8. Borrowings Our credit agreements with commercial banks in Puerto Rico include certain customary financial and non-financial covenants, including negative covenants imposing certain restrictions on the Company’s business. For one of our credit agreements, covering three term loans, the Company was not in compliance with the Debt Service Coverage Ratio covenant of the credit agreement during the quarter ended September 30, 2021. As of September 30, 2021 and December 31, 2020, the outstanding balance of the debt was $20,217 and $22,644, respectively. On November 1, 2021, the financial banking institution waived the Company’s obligation to comply with this covenant for the quarter ended September 30, 2021 and quarters ending on December 31, 2021 and March 31, 2022. The Company has several short-term facilities available to address timing differences between cash receipts and disbursements, consisting of collateralized advances from FHLBNY and a revolving credit facility. • In August 2019, TSS and TSV became members of the FHLBNY, which provides access to collateralized advances. The borrowing capacity of TSS and TSV is up to 15% and 10%, respectively, of their admitted assets as disclosed in the most recent filing with the Commissioner of Insurance but is constrained by the amount of collateral held at the FHLBNY (see Note 3). As of September 30, 2021 and December 31, 2020, the borrowing capacity was approximately $192,430 and $200,338, respectively. There was no outstanding balance as of September 30, 2021. As of December 31, 2020 the outstanding balance was $30,000. The average interest rate of the outstanding balance was 0.33% as of December 31, 2020. • TSA has a $10,000 revolving loan agreement with a commercial bank in Puerto Rico. This line of credit has an interest rate of 30-day LIBOR plus 250 basis points and contains certain financial and non-financial covenants that are customary for this type of facility. This line of credit matured on June 30, 2021 and was renewed for an additional year. There was

Pension Plan

Pension Plan	9 Months Ended
	Sep. 30, 2021
Pension Plan [Abstract]
Pension Plan	9. Pension Plan The components of net periodic benefit cost were as follows: Three months ended September 30, Nine months ended September 30, 2021 2020 2021 2020 Components of net periodic benefit cost: Interest cost $ 1,370 $ 1,474 $ 4,120 $ 4,554 Expected return on assets (1,098 ) (2,211 ) (3,298 ) (6,629 ) Amortization of actuarial loss 994 396 2,944 884 Settlement loss 1,359 356 3,359 1,068 Net periodic benefit cost (income) $ 2,625 $ 15 $ 7,125 $ (123 ) Employer Contributions:

Reinsurance

Reinsurance	9 Months Ended
	Sep. 30, 2021
Reinsurance [Abstract]
Reinsurance	10. Reinsurance Triple-S Propiedad, Inc. (TSP) uses facultative reinsurance, pro rata, and excess of loss reinsurance treaties to manage its exposure to losses, including those from catastrophe events. TSP has geographic exposure to catastrophe losses from hurricanes and earthquakes. The incidence and severity of catastrophes are inherently unpredictable. Under these treaties, TSP ceded premiums written were $14,791 and $14,920 for the three months ended September 30, 2021 and 2020, respectively, and $44,245 and $45,637 for the nine months ended September 30, 2021 and 2020, respectively. Ceded incurred losses and loss adjustment expenses during the three months and nine months ended September 30, 2021 and 2020 were $3,926 and $5,419, respectively, and $3,167 and $45,802, respectively. The ceded incurred losses and loss adjustment expenses for the nine months ended September 30, 2020 include $40,000 related to earthquake losses ceded under catastrophe reinsurance. Principal reinsurance agreements are as follows: • Casualty excess of loss treaty provides reinsurance for losses up to $20,000, subject to a retention of $225. • Medical malpractice excess of loss treaty provides reinsurance for losses up to $3,000, subject to a retention of $150. • Property reinsurance treaty includes proportional cessions and a per risk excess of loss contract limiting losses to $400 in $30,000 risks. • Catastrophe protection is purchased limiting losses to $5,000 per event with losses up to approximately $811,450 in a $816,450 event. All principal reinsurance contracts are for a period of one year and are subject to modifications and negotiations in each renewal. TSP’s current property and catastrophe reinsurance program was renewed effective April 1, 2021 for a twelve-month period ending March 31, 2022. Other contracts that expired on January 1, 2021 were renewed.

Comprehensive Income (Loss)

Comprehensive Income (Loss)	9 Months Ended
	Sep. 30, 2021
Comprehensive Income (Loss) [Abstract]
Comprehensive Income (Loss)	11. Comprehensive Income (Loss) The accumulated balances for each classification of other comprehensive income (loss), net of tax, are as follows: Three months ended September 30, Nine September 30 2021 2020 2021 2020 Net Unrealized Gain on Securities Beginning Balance $ 77,399 $ 85,110 $ 91,689 $ 57,830 Other comprehensive income (loss) before reclassifications 1,233 5,149 (10,872 ) 31,879 Amounts reclassified from accumulated other comprehensive (loss) income (812 ) (406 ) (2,997 ) 144 Net current period change 421 4,743 (13,869 ) 32,023 Ending Balance 77,820 89,853 77,820 89,853 Liability for Pension Benefits Beginning Balance (100,291 ) (28,161 ) (101,509 ) (28,467 ) Amounts reclassified from accumulated other comprehensive income 621 247 1,839 553 Ending Balance (99,670 ) (27,914 ) (99,670 ) (27,914 ) Accumulated Other Comprehensive (Loss) Income Beginning Balance (22,892 ) 56,949 (9,820 ) 29,363 Other comprehensive income (loss) before reclassifications 1,233 5,149 (10,872 ) 31,879 Amounts reclassified from accumulated other comprehensive (loss) income (191 ) (159 ) (1,158 ) 697 Net current period change 1,042 4,990 (12,030 ) 32,576 Ending Balance $ (21,850 ) $ 61,939 $ (21,850 ) $ 61,939

Share-Based Compensation

Share-Based Compensation	9 Months Ended
	Sep. 30, 2021
Share-Based Compensation [Abstract]
Share-Based Compensation	12. Share-Based Compensation Share-based compensation expense recorded during the three months ended and was $ and $ , respectively. Share-based compensation expense recorded during the nine months ended September 30, 2021 and 2020 was $ and $ , respectively. During the three months ended September 30, 2021, and 2020, and 14,040 shares were repurchased and retired as the result of non-cash tax withholdings upon vesting of shares. During the nine months ended and 2020, and 20,922 shares were repurchased and retired as the result of non-cash tax withholdings upon

Net Income Available to Stockho

Net Income Available to Stockholders and Net Income per Share	9 Months Ended
	Sep. 30, 2021
Net Income Available to Stockholders and Net Income per Share [Abstract]
Net Income Available to Stockholders and Net Income per Share	13. Net Income Available to Stockholders and Net Income per Share The following table sets forth the computation of basic and diluted earnings per share: Three months ended September 30, Nine months ended September 30, 2021 2020 2021 2020 Numerator for earnings per share: Net income attributable to TSM available to stockholders $ 8,167 $ 23,581 $ 55,037 $ 41,035 Denominator for basic earnings per share: Weighted average of common shares 23,494,415 23,073,511 23,402,622 23,215,840 Effect of dilutive securities 116,257 120,469 143,655 102,229 Denominator for diluted earnings per share 23,610,672 23,193,980 23,546,277 23,318,069 Basic net income per share attributable to TSM $ 0.35 $ 1.02 $ 2.35 $ 1.77 Diluted net income per share attributable to TSM $ 0.35 $ 1.02 $ 2.34 $ 1.76

Contingencies

Contingencies	9 Months Ended
	Sep. 30, 2021
Contingencies [Abstract]
Contingencies	14. Contingencies The following information supplements and amends, as applicable, the disclosures in Note 25 to the Consolidated Financial Statements of the Company’s 2020 Annual Report on Form 10-K. The Company’s business is subject to numerous laws and regulations promulgated by Federal, Puerto Rico, U.S. Virgin Islands (USVI), Costa Rica, British Virgin Islands (BVI), and Anguilla governmental authorities. Compliance with these laws and regulations can be subject to government review and interpretation, as well as regulatory actions unknown and unasserted at this time. The Commissioner of Insurance of Puerto Rico, as well as other Federal, Puerto Rico, USVI, Costa Rica, BVI, and Anguilla government authorities, regularly make inquiries and conduct audits concerning the Company's compliance with such laws and regulations. Penalties associated with violations of these laws and regulations may include significant fines and exclusion from participating in certain publicly funded programs and may require the Company to comply with corrective action plans or changes in our practices. The Company is involved in various legal actions arising in the ordinary course of business. The Company is also defendant in various other litigations and proceedings, some of which are described below. Where the Company believes that a loss is both probable and estimable, such amounts have been recorded. Although the Company believes the estimates of such losses are reasonable, these estimates could change as a result of further developments in these matters. In other cases, it is at least reasonably possible that the Company may incur a loss related to one or more of the mentioned pending lawsuits or investigations, but the Company is unable to estimate the range of possible loss which may be ultimately realized, either individually or in the aggregate, upon their resolution. However, there are legal proceedings where a loss is reasonably possible, and for which it is possible to reasonably estimate the amount of the possible loss or range of losses. We currently believe that on September 30, 2021, the range of possible losses for such proceedings in excess of established reserves is, in the aggregate, from $0 to approximately $10,000. The outcome of legal proceedings is inherently uncertain; pending matters for which accruals have not been established have not progressed sufficiently to enable us to estimate a range of possible loss, if any. Given the inherent unpredictability of these matters, it is possible that an adverse outcome in one or more of these matters could have a material effect on the consolidated financial condition, operating results and/or cash flows of the Company. Additionally, we may face various potential litigation claims that have not been asserted to date. In re Blue Cross Blue Shield Antitrust Litigation TSS is a co-defendant with multiple Blue Plans and the Blue Cross Blue Shield Association in a multi-district class action litigation filed by a group of providers and subscribers on July 24, 2012 and October 1, 2012, respectively, that has since been consolidated by the United States District Court for the Northern District of Alabama, Southern Division, in the case captioned In re Blue Cross Blue Shield Association Antitrust Litigation. Essentially, provider plaintiffs allege that the exclusive service area requirements of the Primary License Agreements with the Blue Plans constitute an illegal horizontal market allocation under federal antitrust laws. As per provider plaintiffs, the quid pro quo for said “market allocation” is a horizontal price fixing and boycott conspiracy implemented through BCBSA and whose benefits are allegedly derived through the BCBSA’s BlueCard/National Accounts Program. Among the remedies sought, provider plaintiffs seek increased compensation rates and operational changes. In turn, subscriber plaintiffs allege that the alleged conspiracy to allocate markets have prevented subscribers from being offered competitive prices and resulted in higher premiums for Blue Plan subscribers. Subscribers seek damages for the amounts that the Blue Plan premiums allegedly have been artificially inflated as a result of the alleged antitrust violations. Both actions seek injunctive relief. Prior to consolidation, motions to dismiss were filed by several plans, including TSS, whose request was ultimately denied by the court without prejudice. On April 6, 2015, plaintiffs filed suit in the United States District Court of Puerto Rico against TSS. Said complaint, nonetheless, is believed not to preclude TSS’ jurisdictional arguments. Since inception, the Company has joined BCBSA and other Blue Plans in vigorously contesting these claims. On April 5, 2018, the United States District Court for the Northern District of Alabama, Southern Division, issued its ruling on the parties’ respective motions for partial summary judgment on the standard of review applicable to plaintiffs’ claims under Section 1 of the Sherman Act and subscriber plaintiffs’ motion for partial summary judgment on the Blue Plan’s single entity defense. After considering the “undisputed” facts (for summary judgment purposes only) and evidence currently on record in the light most favorable to defendants, the court essentially found that: (a) the combination of Exclusive Service Areas and the National Best Efforts Rule are subject to the Per Se standard of review; (b) there remain genuine issues of material fact as to whether defendants’ conduct can be shielded by the “single entity” defense; and (c) claims concerning the BlueCard Program and uncoupling rules are due to be analyzed under the Rule of Reason standard. On April 16, 2018, Defendants moved the Federal District Court for the Northern District of Alabama to certify for immediate interlocutory appeal the Court’s April 5, 2018 Standard of Review Ruling. On June 12, 2018 Hon. Judge Proctor agreed to grant Defendant’s motion for certification pursuant to 28 U.S.C. §1292(b). Defendants filed their Notice of Appeal on July 12, 2018. On December 12, 2018, the Court of Appeals for the Eleventh Circuit denied Defendants’ petition to appeal the District Court’s Standard of Review Ruling. On July 29, 2020, the Defendants reached a settlement agreement with subscribers, which was subject to approval by the BCBSA and Member Plans boards, as well as from the Federal District Court for the Northern District of Alabama. Following the BCBSA Board of Directors and Members Plans’ August 14, 2020 approval, on September 30, 2020, the Company’s Board of Directors voted to approve the Settlement Agreement. On November 30, 2020, the Federal District Court for the Northern District of Alabama issued its Memorandum Opinion and Preliminary Order approving settlement terms. The Settlement Agreement requires a monetary settlement payment from defendants. On March 1, 2021, the plans finished producing the data for settlement notice and allocation. The deadline for class members to opt-out or file objections to Settlement was July 28, 2021. The Company's portion of the monetary settlement payment was estimated at $32,000, which was accrued during the year ended December 31, 2020. As of September 30, 2021 the accrued amount related to this contingency was $27,364. Following the suspension of negotiation efforts with providers and the stay of litigation proceedings from July 2019 to October 2020, providers resumed their mediation efforts with Defendants in October 2021.

Segment Information

Segment Information	9 Months Ended
	Sep. 30, 2021
Segment Information [Abstract]
Segment Information	15. Segment Information The operations of the Company are conducted principally through three reportable business segments: Managed Care, Life Insurance, and Property and Casualty Insurance. The Company evaluates performance based primarily on the operating revenues and operating income of each segment. Operating revenues include Premiums Earned, Net, Administrative Service Fees and Net Investment Income. Operating costs include Claims Incurred and Operating Expenses. The Company calculates operating income or loss as operating revenues less operating costs. The following tables summarize the operations by reportable segment for the three months and nine months ended September 30, 2021 and 2020: Three months ended September 30, Nine months ended September 30, 2021 2020 2021 2020 Operating revenues Managed Care: Premiums earned, net $ 939,210 $ 849,529 $ 2,779,869 $ 2,447,588 Administrative service fees 3,875 3,013 9,316 8,755 Intersegment premiums/service fees 598 644 2,319 2,624 Net investment income 8,088 5,065 19,088 14,763 Total Managed Care 951,771 858,251 2,810,592 2,473,730 Life Insurance: Premiums earned, net 54,394 49,616 159,783 143,325 Intersegment premiums 636 516 1,811 1,552 Net investment income 6,785 6,900 19,851 20,625 Total Life Insurance 61,815 57,032 181,445 165,502 Property and Casualty Insurance: Premiums earned, net 26,092 23,789 76,360 66,453 Intersegment premiums 153 153 460 460 Net investment income 2,569 2,103 6,847 6,551 Total Property and Casualty insurance 28,814 26,045 83,667 73,464 Other segments: * Intersegment service revenues 2,229 2,595 9,678 7,637 Operating revenues from external sources 3,925 2,052 8,518 6,394 Total other segments 6,154 4,647 18,196 14,031 Total business segments 1,048,554 945,975 3,093,900 2,726,727 TSM operating revenues from external sources 130 100 392 355 Elimination of intersegment premiums/service fees (1,387 ) (574 ) (4,590 ) (4,636 ) Elimination of intersegment service revenues (2,229 ) (2,595 ) (9,678 ) (7,637 ) Consolidated operating revenues $ 1,045,068 $ 942,906 $ 3,080,024 $ 2,714,809 * Includes segments that are not required to be reported separately, primarily the health clinics. Three months ended September 30, Nine months ended September 30, 2021 2020 2021 2020 Operating income (loss): Managed Care $ 8,532 $ 13,006 $ 34,496 $ 56,495 Life Insurance 5,591 5,682 17,772 20,188 Property and Casualty insurance 1,975 4,386 7,763 10,921 Other segments * (2,161 ) (1,639 ) (6,593 ) (4,552 ) Total business segments 13,937 21,435 53,438 83,052 TSM operating revenues from external sources 130 100 392 355 TSM unallocated operating expenses (4,875 ) (1,633 ) (11,464 ) (4,877 ) Elimination of TSM intersegment charges 2,403 2,403 7,209 7,209 Consolidated operating income 11,595 22,305 49,575 85,739 Consolidated net realized investment gains (losses) 1,015 507 3,746 (180 ) Consolidated net unrealized investment (losses) gains on equity investments (7,912 ) 11,040 13,383 (17,428 ) Consolidated interest expense (2,016 ) (2,096 ) (6,225 ) (5,813 ) Consolidated other income, net 11,085 1,811 19,047 6,217 Consolidated income before taxes $ 13,767 $ 33,567 $ 79,526 $ 68,535 Depreciation and amortization expense: Managed Care $ 2,319 $ 2,085 $ 7,111 $ 8,061 Life Insurance 320 289 965 869 Property and Casualty insurance 72 93 216 296 Other segments* 355 240 1,057 913 Total business segments 3,066 2,707 9,349 10,139 TSM depreciation expense 488 404 1,318 716 Consolidated depreciation and amortization expense $ 3,554 $ 3,111 $ 10,667 $ 10,855 * Includes segments that are not required to be reported separately, primarily the health clinics. September 30, 2021 December 31, 2020 Assets: Managed Care $ 1,456,710 $ 1,319,389 Life Insurance 1,095,884 1,051,819 Property and Casualty Insurance 508,783 583,404 Other segments * 35,854 34,020 Total business segments 3,097,231 2,988,632 Unallocated amounts related to TSM: Cash, cash equivalents, and investments 16,945 16,489 Property and equipment, net 74,209 68,678 Other assets 90,257 88,684 181,411 173,851 Elimination entries-intersegment receivables and others (86,976 ) (74,065 ) Consolidated total assets $ 3,191,666 $ 3,088,418 * Includes segments that are not required to be reported separately, primarily the health clinics.

Subsequent Events

Subsequent Events	9 Months Ended
	Sep. 30, 2021
Subsequent Events [Abstract]
Subsequent Events	16. Subsequent Events The Company evaluated subsequent events through the date the unaudited condensed consolidated interim financial statements were issued. No events, other than those described in these notes, have occurred that require adjustment or disclosure pursuant to current Accounting Standard Codification.

Basis of Presentation (Policies

Basis of Presentation (Policies)	9 Months Ended
	Sep. 30, 2021
Basis of Presentation [Abstract]
Basis of Presentation	The accompanying condensed consolidated interim financial statements prepared by Triple-S Management Corporation (Triple-S, TSM, the Company, the Corporation, we, us or our) and its subsidiaries are unaudited. The condensed consolidated interim financial statements do not include all the information and the footnotes required by accounting principles generally accepted in the United States of America (GAAP or U.S. GAAP) for complete financial statement presentation pursuant to the rules and regulations of the Securities and Exchange Commission (SEC). Accordingly, these condensed consolidated interim financial statements should be read in conjunction with the audited consolidated financial statements included in the Company’s Annual Report on Form 10-K for the year ended December 31, 2020. 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 and nine months ended September 30, 2021 are not necessarily indicative of the results for the full year ending December 31, 2021.

Significant Accounting Polici_2

Significant Accounting Policies (Policies)	9 Months Ended
	Sep. 30, 2021
Significant Accounting Policies [Abstract]
Recently Adopted Accounting Standards and Future Adoptions of Accounting Standards	Recently Adopted Accounting Standards On August 28, 2018, the Financial Accounting Standards Board (FASB) issued guidance for Compensation – Retirement Benefits – Defined Benefit Plans – General which addresses changes to the disclosure requirement for defined benefit plans. The amendments in this guidance modify the disclosure requirements for employers that sponsor defined benefit pension or other postretirement plans. Specifically, the guidance removes certain disclosure requirements, including the amounts of accumulated other comprehensive income expected to be recognized as components of net periodic benefit cost over the next fiscal year, related-party disclosures concerning the amount of future annual benefits covered by insurance and annuity contracts and significant transactions between the employer and related-parties and the plan, and adds other disclosures including the weighted-average interest crediting rates for cash balance plans and other plans with promised interest crediting rates, and an explanation for the reasons for significant gains and losses related to changes in the benefit obligation for the period. The Company adopted the standard effective January 1, 2021. The adoption of this guidance did not have a material impact on the presentation and disclosures of the Company’s consolidated financial statements. On December 18, 2019, the FASB issued Accounting Standards Update (ASU) 2019-12: Income Taxes (Topic 740): Simplifying the Accounting for Income Taxes. The amendments in this update simplify the accounting for income taxes by removing certain exceptions to the general principles in Topic 740. Also, the amendments simplify the accounting for income taxes by requiring the following: (1) that an entity recognize a franchise tax that is partially based on income in accordance with Topic 740 and account for any incremental amount incurred as a non-income-based tax; (2) that an entity evaluate when a step-up in the tax basis of Goodwill should be considered part of the business combination in which the book goodwill was originally recognized and when it should instead be considered a separate transaction; and (3) that an entity reflect the effect of an enacted change in tax laws or rates in the annual effective tax rate computation in the interim period that included the enactment date. The Company adopted the standard effective January 1, 2021. The adoption of this guidance did not have a material impact on the results of the Company’s consolidated financial statements. On January 16, 2020, the FASB issued guidance to clarify the interaction between the accounting standards on recognition and measurement of financial instruments in Topic 321: Investments – Equity Securities, the one on equity method investments in Topic 323: Investments – Equity Method and Joint Ventures, and forward contracts and purchased options in Topic 815: Derivatives and Hedging. The amendments clarify that upon an increase or decrease in level of ownership or degree of influence, a company should remeasure the interest held in the investee to take into account observable transactions immediately before applying or discontinuing the equity method of accounting under Topic 323. The guidance also clarifies that an entity should not consider whether, upon the settlement of the forward contract or exercise of the purchase option, individually or with existing investments, the underlying securities would be accounted for under the equity method in Topic 323 or the fair value option. The Company adopted the standard effective January 1, 2021. The adoption of this guidance did not have a material impact on the results of the Company’s consolidated financial statements. Future Adoptions of Accounting Standards On January 7, 2021, the FASB issued ASU 2021-01: Reference Rate Reform (Topic 848): Scope Refinement – to clarify the scope of the recent reference reform guidance in Topic 848. This ASU refines the scope of Topic 848 and clarifies that certain optional expedients and exceptions therein for contract modifications and hedge accounting apply to contracts that are affected by the discounting transition. Specifically, modifications related to reference rate reform would not be considered an event that requires reassessment of previous accounting conclusions. The ASU also amends the expedients and exceptions in Topic 848 to capture the incremental consequences of the scope clarification and to tailor the existing guidance to derivative instruments affected by the discounting transition. The amendments in the ASU are effective immediately for all entities. The Company is currently in the process of identifying its LIBOR-based contracts that will be affected by the phase-out of LIBOR and expects to use the optional expedients provided in this ASU. Other than the accounting pronouncements disclosed above, there were no other new accounting pronouncements issued during the three and nine months ended September 30, 2021 that could have a material impact on the Company’s financial position, operating results or financials statement disclosures.

Investment in Securities (Table

Investment in Securities (Tables)	9 Months Ended
	Sep. 30, 2021
Investment in Securities [Abstract]
Amortized Cost and Estimated Fair Value for Available-for-Sale and Held-to-Maturity Securities by Major Security Type and Class of Security	The amortized cost for debt securities and alternative investments, gross unrealized gains and losses, and estimated fair value for the Company’s investments in securities by major security type and class of security as of September 30, 2021, and December 31, 2020, were as follows: September 30, 2021 Amortized cost Gross unrealized gains Gross unrealized losses Estimated fair value Fixed-maturities available-for-sale Obligations of government-sponsored enterprises $ 21,303 $ 294 $ (53 ) $ 21,544 U.S. Treasury securities and obligations of U.S. government instrumentalities 104,546 5,367 (4 ) 109,909 Municipal securities 611,211 40,598 (853 ) 650,956 Corporate bonds 177,640 23,510 (69 ) 201,081 Residential mortgage-backed securities 284,745 16,807 (546 ) 301,006 Collateralized mortgage obligations 5,301 437 - 5,738 Total fixed-maturities available-for-sale $ 1,204,746 $ 87,013 $ (1,525 ) $ 1,290,234 December 31, 2020 Amortized cost Gross unrealized gains Gross unrealized losses Estimated fair value Fixed-maturities available-for-sale Obligations of government-sponsored enterprises $ 24,496 $ 665 $ (9 ) $ 25,152 U.S. Treasury securities and obligations of U.S. government instrumentalities 103,694 7,993 - 111,687 Municipal securities 646,961 54,067 - 701,028 Corporate bonds 189,516 30,280 - 219,796 Residential mortgage-backed securities 249,801 21,487 (57 ) 271,231 Collateralized mortgage obligations 12,954 638 (21 ) 13,571 Total fixed-maturities available-for-sale $ 1,227,422 $ 115,130 $ (87 ) $ 1,342,465 September 30, 2021 Amortized cost Gross unrealized gains Gross unrealized losses Estimated fair value Fixed-maturities held-to-maturity U.S. Treasury securities and obligations of U.S. government instrumentalities $ 613 $ 154 $ - $ 767 Residential mortgage-backed securities 164 8 - 172 Certificates of deposit 1,093 - - 1,093 Total fixed-maturities held-to-maturity $ 1,870 $ 162 $ - $ 2,032 December 31, 2020 Amortized cost Gross unrealized gains Gross unrealized losses Estimated fair value Fixed-maturities held-to-maturity U.S. Treasury securities and obligations of U.S. government instrumentalities $ 614 $ 201 $ - $ 815 Residential mortgage-backed securities 164 17 - 181 Certificates of deposit 1,089 - - 1,089 Total fixed-maturities held-to-maturity $ 1,867 $ 218 $ - $ 2,085 September 30, 2021 Amortized cost Gross unrealized gains Gross unrealized losses Estimated fair value Other invested assets - Alternative investments $ 105,151 $ 17,908 $ (3,663 ) $ 119,396 December 31, 2020 Amortized cost Gross unrealized gains Gross unrealized losses Estimated fair value Other invested assets - Alternative investments $ 112,171 $ 6,119 $ (3,385 ) $ 114,905
Securities in Continuous Unrealized Loss Position	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, 2021 and December 31, 2020 were as follows: September 30, 2021 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 Fixed-maturities available-for-sale Obligations of government-sponsored enterprises $ 4,665 $ (22 ) 4 $ 1,518 $ (31 ) 1 $ 6,183 $ (53 ) 5 U.S. Treasury securities and obligations of U.S. government instrumentalities 983 (4 ) 1 - - - 983 (4 ) 1 Municipal securities 70,535 (853 ) 16 - - - 70,535 (853 ) 16 Corporate bonds 3,931 (69 ) 1 - - - 3,931 (69 ) 1 Residential mortgage-backed securities 48,592 (546 ) 13 - - - 48,592 (546 ) 13 Total fixed-maturities available-for-sale $ 128,706 $ (1,494 ) 35 $ 1,518 $ (31 ) 1 $ 130,224 $ (1,525 ) 36 Other invested assets - Alternative investments $ 2,439 $ (105 ) 2 $ 18,022 $ (3,558 ) 7 $ 20,461 $ (3,663 ) 9 December 31, 2020 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 Fixed-maturities available-for-sale Obligations of government-sponsored enterprises $ 1,539 $ (9 ) 1 $ - $ - - $ 1,539 $ (9 ) 1 Residential mortgage-backed securities 3,624 (57 ) 1 - - - 3,624 (57 ) 1 Collateralized mortgage obligations 6,060 (21 ) 2 - - - 6,060 (21 ) 2 Total fixed-maturities available-for-sale $ 11,223 $ (87 ) 4 $ - $ - - $ 11,223 $ (87 ) 4 Other invested assets - Alternative investments $ 12,584 $ (808 ) 4 $ 16,396 $ (2,577 ) 6 $ 28,980 $ (3,385 ) 10
Maturities of Investment Securities Classified as Available for Sale and Held to Maturity	Maturities of investment securities classified as available-for-sale and held-to-maturity were as follows: September 30, 2021 Amortized cost Estimated fair value Fixed-maturities available-for-sale Due in one year or less $ 60,380 $ 61,218 Due after one year through five years 572,854 605,722 Due after five years through ten years 149,432 157,360 Due after ten years 132,034 159,190 Residential mortgage-backed securities 284,745 301,006 Collateralized mortgage obligations 5,301 5,738 $ 1,204,746 $ 1,290,234 Fixed-maturities held-to-maturity Due in one year or less $ 1,093 $ 1,093 Due after ten years 613 767 Residential mortgage-backed securities 164 172 $ 1,870 $ 2,032

Realized and Unrealized Gains_2

Realized and Unrealized Gains (Losses) (Tables)	9 Months Ended
	Sep. 30, 2021
Realized and Unrealized Gains (Losses) [Abstract]
Realized Gains and Losses from Investments	Information regarding realized and unrealized gains and losses from investments is as follows: Three months ended Nine months ended September 30, September 30, 2021 2020 2021 2020 Realized gains (losses) Fixed-maturity securities Fixed-maturities available-for-sale Gross gains $ - $ 402 $ 90 $ 1,953 Gross losses (138 ) (1 ) (1,104 ) (7 ) Total fixed-maturity securities (138 ) 401 (1,014 ) 1,946 Equity investments Gross gains 238 67 2,121 1,057 Gross losses (19 ) (479 ) (438 ) (3,249 ) Gross losses from impaired securities - - - (678 ) Total equity investments 219 (412 ) 1,683 (2,870 ) Other invested assets Gross gains 934 518 3,077 744 Total other invested assets 934 518 3,077 744 Net realized gains (losses) on securities $ 1,015 $ 507 $ 3,746 $ (180 )
Changes in Net Unrealized Gains (Losses)	The gross losses from impaired securities during the nine months ended September 30, 2020 are Three months ended September 30, Nine months ended September 30, 2021 2020 2021 2020 Changes in net unrealized gains (losses): Recognized in accumulated other comprehensive income (loss): Fixed-maturities – available-for-sale $ (3,742 ) $ 4,705 $ (29,555 ) $ 44,943 Other invested assets 4,136 1,498 11,511 (2,700 ) $ 394 $ 6,203 $ (18,044 ) $ 42,243 Not recognized in the consolidated financial statements: Fixed-maturities – held-to-maturity $ (11 ) $ (6 ) $ (56 ) $ 64

Premiums and Other Receivable_2

Premiums and Other Receivables, Net (Tables)	9 Months Ended
	Sep. 30, 2021
Premiums and Other Receivables, Net [Abstract]
Premium and Other Receivables, Net	Premiums and Other Receivables, Net were as follows: September 30, 2021 December 31, 2020 Premiums $ 177,298 $ 106,322 Self-funded group receivables 27,767 26,412 FEHBP 15,002 12,830 Agent balances 30,235 31,509 Accrued interest 9,206 10,418 Reinsurance recoverable 157,665 216,314 Other 128,988 135,774 546,161 539,579 Less allowance for doubtful receivables: Premiums 34,433 37,231 Other 15,251 13,508 49,684 50,739 Total premium and other receivables, net $ 496,477 $ 488,840

Fair Value Measurements (Tables

Fair Value Measurements (Tables)	9 Months Ended
	Sep. 30, 2021
Fair Value Measurements [Abstract]
Fair Value Measurements by Level for Assets Measured at Fair Value on a Recurring Basis	The following tables summarize fair value measurements by level for assets measured at fair value on a recurring basis: September 30, 2021 Level 1 Level 2 Level 3 Total Fixed-maturities available-for-sale Obligations of government-sponsored enterprises $ - $ 21,544 $ - $ 21,544 U.S. Treasury securities and obligations of U.S. government instrumentalities 109,909 - - 109,909 Municipal securities - 650,956 - 650,956 Corporate bonds - 201,081 - 201,081 Residential agency mortgage-backed securities - 301,006 - 301,006 Collateralized mortgage obligations - 5,738 - 5,738 Total fixed-maturities available-for-sale $ 109,909 $ 1,180,325 $ - $ 1,290,234 Equity investments $ 276,531 $ 236,893 $ 5,341 $ 518,765 December 31, 2020 Level 1 Level 2 Level 3 Total Fixed-maturities available-for-sale Obligations of government-sponsored enterprises $ - $ 25,152 $ - $ 25,152 U.S. Treasury securities and obligations of U.S. government instrumentalities 111,687 - - 111,687 Municipal securities - 701,028 - 701,028 Corporate bonds - 219,796 - 219,796 Residential agency mortgage-backed securities - 271,231 - 271,231 Collateralized mortgage obligations - 13,571 - 13,571 Total fixed-maturities available-for-sale $ 111,687 $ 1,230,778 $ - $ 1,342,465 Equity investments $ 220,118 $ 179,108 $ 5,102 $ 404,328
Reconciliation of Assets Measured at Fair Value on Recurring Basis	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 and nine months ended September 30 is as follows: Fair Value Measurements Using Significant Unobservable Inputs (Level 3) Three months ended Nine months ended September 30, 2021 September 30, 2021 Beginning Balance $ 5,199 $ 5,102 Unrealized in other accumulated comprehensive income 142 239 Ending Balance $ 5,341 $ 5,341

Claim Liabilities (Tables)

Claim Liabilities (Tables)	9 Months Ended
	Sep. 30, 2021
Claim Liabilities [Abstract]
Reconciliation of Beginning and Ending Balances of Claim Liabilities	The tables below present a reconciliation of the beginning and ending balances of Claim Liabilities during the nine months ended September 30: Nine months ended September 30, 2021 Managed Care Other Business Segments * Consolidated Claim liabilities at beginning of period $ 445,655 $ 341,447 $ 787,102 Reinsurance recoverable on claim liabilities - (138,816 ) (138,816 ) Net claim liabilities at beginning of period 445,655 202,631 648,286 Claims incurred Current period insured events 2,485,095 92,526 2,577,621 Prior period insured events (35,986 ) 982 (35,004 ) Total 2,449,109 93,508 2,542,617 Payments of losses and loss-adjustment expenses Current period insured events 2,124,676 47,360 2,172,036 Prior period insured events 236,405 63,086 299,491 Total 2,361,081 110,446 2,471,527 Net claim liabilities at end of period 533,683 185,693 719,376 Reinsurance recoverable on claim liabilities - 79,132 79,132 Claim liabilities at end of period $ 533,683 $ 264,825 $ 798,508 * Other Business Segments include the Life Insurance and Property and Casualty segments, as well as intersegment eliminations. Nine months ended September 30, 2020 Managed Care Other Business Segments * Consolidated Claim liabilities at beginning of period $ 341,277 $ 367,981 $ 709,258 Reinsurance recoverable on claim liabilities - (137,017 ) (137,017 ) Net claim liabilities at beginning of period 341,277 230,964 572,241 Claims incurred Current period insured events 2,000,825 84,358 2,085,183 Prior period insured events 24,297 (7,885 ) 16,412 Total 2,025,122 76,473 2,101,595 Payments of losses and loss-adjustment expenses Current period insured events 1,678,400 45,815 1,724,215 Prior period insured events 267,427 41,081 308,508 Total 1,945,827 86,896 2,032,723 Net claim liabilities at end of period 420,572 220,541 641,113 Reinsurance recoverable on claim liabilities - 145,807 145,807 Claim liabilities at end of period $ 420,572 $ 366,348 $ 786,920 * Other Business Segments include the Life Insurance and Property and Casualty segments, as well as intersegment eliminations.
Incurred and Paid Claims Development, Net of Reinsurance and Total Incurred But Not Reported Liabilities Plus Expected Development on Reported Claims Included in Net Incurred Claims Amounts	The following is information about incurred and paid claims development, net of reinsurance, as of September 30, 2021, as well as cumulative claim frequency. Additional information presented includes total incurred-but-not-reported liabilities plus expected development on reported claims which is included within the net incurred claims amounts. Incurred Year Total of IBNR Liabilities Plus Expected Development on Reported Claims 2020 $ 119,675 2021 360,419

Pension Plan (Tables)

Pension Plan (Tables)	9 Months Ended
	Sep. 30, 2021
Pension Plan [Abstract]
Components of Net Periodic Benefit	The components of net periodic benefit cost were as follows: Three months ended September 30, Nine months ended September 30, 2021 2020 2021 2020 Components of net periodic benefit cost: Interest cost $ 1,370 $ 1,474 $ 4,120 $ 4,554 Expected return on assets (1,098 ) (2,211 ) (3,298 ) (6,629 ) Amortization of actuarial loss 994 396 2,944 884 Settlement loss 1,359 356 3,359 1,068 Net periodic benefit cost (income) $ 2,625 $ 15 $ 7,125 $ (123 )

Comprehensive Income (Loss) (Ta

Comprehensive Income (Loss) (Tables)	9 Months Ended
	Sep. 30, 2021
Comprehensive Income (Loss) [Abstract]
Accumulated Balances of Other Comprehensive Income (Loss), Net of Tax	The accumulated balances for each classification of other comprehensive income (loss), net of tax, are as follows: Three months ended September 30, Nine September 30 2021 2020 2021 2020 Net Unrealized Gain on Securities Beginning Balance $ 77,399 $ 85,110 $ 91,689 $ 57,830 Other comprehensive income (loss) before reclassifications 1,233 5,149 (10,872 ) 31,879 Amounts reclassified from accumulated other comprehensive (loss) income (812 ) (406 ) (2,997 ) 144 Net current period change 421 4,743 (13,869 ) 32,023 Ending Balance 77,820 89,853 77,820 89,853 Liability for Pension Benefits Beginning Balance (100,291 ) (28,161 ) (101,509 ) (28,467 ) Amounts reclassified from accumulated other comprehensive income 621 247 1,839 553 Ending Balance (99,670 ) (27,914 ) (99,670 ) (27,914 ) Accumulated Other Comprehensive (Loss) Income Beginning Balance (22,892 ) 56,949 (9,820 ) 29,363 Other comprehensive income (loss) before reclassifications 1,233 5,149 (10,872 ) 31,879 Amounts reclassified from accumulated other comprehensive (loss) income (191 ) (159 ) (1,158 ) 697 Net current period change 1,042 4,990 (12,030 ) 32,576 Ending Balance $ (21,850 ) $ 61,939 $ (21,850 ) $ 61,939

Net Income Available to Stock_2

Net Income Available to Stockholders and Net Income per Share (Tables)	9 Months Ended
	Sep. 30, 2021
Net Income Available to Stockholders and Net Income per Share [Abstract]
Computation of Basic and Diluted Earnings per Share	The following table sets forth the computation of basic and diluted earnings per share: Three months ended September 30, Nine months ended September 30, 2021 2020 2021 2020 Numerator for earnings per share: Net income attributable to TSM available to stockholders $ 8,167 $ 23,581 $ 55,037 $ 41,035 Denominator for basic earnings per share: Weighted average of common shares 23,494,415 23,073,511 23,402,622 23,215,840 Effect of dilutive securities 116,257 120,469 143,655 102,229 Denominator for diluted earnings per share 23,610,672 23,193,980 23,546,277 23,318,069 Basic net income per share attributable to TSM $ 0.35 $ 1.02 $ 2.35 $ 1.77 Diluted net income per share attributable to TSM $ 0.35 $ 1.02 $ 2.34 $ 1.76

Segment Information (Tables)

Segment Information (Tables)	9 Months Ended
	Sep. 30, 2021
Segment Information [Abstract]
Operating Revenues by Major Operating Segment	The following tables summarize the operations by reportable segment for the three months and nine months ended September 30, 2021 and 2020: Three months ended September 30, Nine months ended September 30, 2021 2020 2021 2020 Operating revenues Managed Care: Premiums earned, net $ 939,210 $ 849,529 $ 2,779,869 $ 2,447,588 Administrative service fees 3,875 3,013 9,316 8,755 Intersegment premiums/service fees 598 644 2,319 2,624 Net investment income 8,088 5,065 19,088 14,763 Total Managed Care 951,771 858,251 2,810,592 2,473,730 Life Insurance: Premiums earned, net 54,394 49,616 159,783 143,325 Intersegment premiums 636 516 1,811 1,552 Net investment income 6,785 6,900 19,851 20,625 Total Life Insurance 61,815 57,032 181,445 165,502 Property and Casualty Insurance: Premiums earned, net 26,092 23,789 76,360 66,453 Intersegment premiums 153 153 460 460 Net investment income 2,569 2,103 6,847 6,551 Total Property and Casualty insurance 28,814 26,045 83,667 73,464 Other segments: * Intersegment service revenues 2,229 2,595 9,678 7,637 Operating revenues from external sources 3,925 2,052 8,518 6,394 Total other segments 6,154 4,647 18,196 14,031 Total business segments 1,048,554 945,975 3,093,900 2,726,727 TSM operating revenues from external sources 130 100 392 355 Elimination of intersegment premiums/service fees (1,387 ) (574 ) (4,590 ) (4,636 ) Elimination of intersegment service revenues (2,229 ) (2,595 ) (9,678 ) (7,637 ) Consolidated operating revenues $ 1,045,068 $ 942,906 $ 3,080,024 $ 2,714,809 * Includes segments that are not required to be reported separately, primarily the health clinics.
Operating Income (Loss) and Depreciation and Amortization Expense	Three months ended September 30, Nine months ended September 30, 2021 2020 2021 2020 Operating income (loss): Managed Care $ 8,532 $ 13,006 $ 34,496 $ 56,495 Life Insurance 5,591 5,682 17,772 20,188 Property and Casualty insurance 1,975 4,386 7,763 10,921 Other segments * (2,161 ) (1,639 ) (6,593 ) (4,552 ) Total business segments 13,937 21,435 53,438 83,052 TSM operating revenues from external sources 130 100 392 355 TSM unallocated operating expenses (4,875 ) (1,633 ) (11,464 ) (4,877 ) Elimination of TSM intersegment charges 2,403 2,403 7,209 7,209 Consolidated operating income 11,595 22,305 49,575 85,739 Consolidated net realized investment gains (losses) 1,015 507 3,746 (180 ) Consolidated net unrealized investment (losses) gains on equity investments (7,912 ) 11,040 13,383 (17,428 ) Consolidated interest expense (2,016 ) (2,096 ) (6,225 ) (5,813 ) Consolidated other income, net 11,085 1,811 19,047 6,217 Consolidated income before taxes $ 13,767 $ 33,567 $ 79,526 $ 68,535 Depreciation and amortization expense: Managed Care $ 2,319 $ 2,085 $ 7,111 $ 8,061 Life Insurance 320 289 965 869 Property and Casualty insurance 72 93 216 296 Other segments* 355 240 1,057 913 Total business segments 3,066 2,707 9,349 10,139 TSM depreciation expense 488 404 1,318 716 Consolidated depreciation and amortization expense $ 3,554 $ 3,111 $ 10,667 $ 10,855 * Includes segments that are not required to be reported separately, primarily the health clinics.
Assets	September 30, 2021 December 31, 2020 Assets: Managed Care $ 1,456,710 $ 1,319,389 Life Insurance 1,095,884 1,051,819 Property and Casualty Insurance 508,783 583,404 Other segments * 35,854 34,020 Total business segments 3,097,231 2,988,632 Unallocated amounts related to TSM: Cash, cash equivalents, and investments 16,945 16,489 Property and equipment, net 74,209 68,678 Other assets 90,257 88,684 181,411 173,851 Elimination entries-intersegment receivables and others (86,976 ) (74,065 ) Consolidated total assets $ 3,191,666 $ 3,088,418 * Includes segments that are not required to be reported separately, primarily the health clinics.

Investment in Securities, Fixed

Investment in Securities, Fixed Maturities Available-for-Sale (Details) - USD ($) $ in Thousands	Sep. 30, 2021	Dec. 31, 2020
Fixed-maturities available-for-sale [Abstract]
Amortized cost	$ 1,204,746	$ 1,227,422
Gross unrealized gains	87,013	115,130
Gross unrealized losses	(1,525)	(87)
Estimated fair value	1,290,234	1,342,465
Obligations of Government-sponsored Enterprises [Member]
Fixed-maturities available-for-sale [Abstract]
Amortized cost	21,303	24,496
Gross unrealized gains	294	665
Gross unrealized losses	(53)	(9)
Estimated fair value	21,544	25,152
U.S. Treasury Securities and Obligations of U.S. Government Instrumentalities [Member]
Fixed-maturities available-for-sale [Abstract]
Amortized cost	104,546	103,694
Gross unrealized gains	5,367	7,993
Gross unrealized losses	(4)	0
Estimated fair value	109,909	111,687
Municipal Securities [Member]
Fixed-maturities available-for-sale [Abstract]
Amortized cost	611,211	646,961
Gross unrealized gains	40,598	54,067
Gross unrealized losses	(853)	0
Estimated fair value	650,956	701,028
Corporate Bonds [Member]
Fixed-maturities available-for-sale [Abstract]
Amortized cost	177,640	189,516
Gross unrealized gains	23,510	30,280
Gross unrealized losses	(69)	0
Estimated fair value	201,081	219,796
Residential Mortgage-backed Securities [Member]
Fixed-maturities available-for-sale [Abstract]
Amortized cost	284,745	249,801
Gross unrealized gains	16,807	21,487
Gross unrealized losses	(546)	(57)
Estimated fair value	301,006	271,231
Collateralized Mortgage Obligations [Member]
Fixed-maturities available-for-sale [Abstract]
Amortized cost	5,301	12,954
Gross unrealized gains	437	638
Gross unrealized losses	0	(21)
Estimated fair value	$ 5,738	$ 13,571

Investment in Securities, Fix_2

Investment in Securities, Fixed Maturities Held-to-Maturity (Details) - USD ($) $ in Thousands	Sep. 30, 2021	Dec. 31, 2020
Fixed-maturities held-to-maturity [Abstract]
Amortized cost	$ 1,870	$ 1,867
Gross unrealized gains	162	218
Gross unrealized losses	0	0
Estimated fair value	2,032	2,085
U.S. Treasury Securities and Obligations of U.S. Government Instrumentalities [Member]
Fixed-maturities held-to-maturity [Abstract]
Amortized cost	613	614
Gross unrealized gains	154	201
Gross unrealized losses	0	0
Estimated fair value	767	815
Residential Mortgage-backed Securities [Member]
Fixed-maturities held-to-maturity [Abstract]
Amortized cost	164	164
Gross unrealized gains	8	17
Gross unrealized losses	0	0
Estimated fair value	172	181
Certificates of Deposit [Member]
Fixed-maturities held-to-maturity [Abstract]
Amortized cost	1,093	1,089
Gross unrealized gains	0	0
Gross unrealized losses	0	0
Estimated fair value	$ 1,093	$ 1,089

Investment in Securities, Other

Investment in Securities, Other Invested Assets - Alternative Investments (Details) - Other Invested Assets - Alternative investments [Member] - USD ($) $ in Thousands	Sep. 30, 2021	Dec. 31, 2020
Other invested assets - Alternative investments [Abstract]
Amortized cost	$ 105,151	$ 112,171
Gross unrealized gains	17,908	6,119
Gross unrealized losses	(3,663)	(3,385)
Estimated fair value	$ 119,396	$ 114,905

Investment in Securities, Secur

Investment in Securities, Securities in Continuous Unrealized Loss Position (Details) $ in Thousands	Sep. 30, 2021USD ($)Security	Dec. 31, 2020USD ($)Security
Fixed-maturities available-for-sale, estimated fair value [Abstract]
Less than 12 months	$ 128,706	$ 11,223
12 months or longer	1,518	0
Total	130,224	11,223
Fixed maturities available-for-sale, gross unrealized loss [Abstract]
Less than 12 months	(1,494)	(87)
12 months or longer	(31)	0
Total	$ (1,525)	$ (87)
Fixed maturities available-for-sale, number of securities [Abstract]
Less than 12 months | Security	35	4
12 months or longer | Security	1	0
Total | Security	36	4
Obligations of Government-sponsored Enterprises [Member]
Fixed-maturities available-for-sale, estimated fair value [Abstract]
Less than 12 months	$ 4,665	$ 1,539
12 months or longer	1,518	0
Total	6,183	1,539
Fixed maturities available-for-sale, gross unrealized loss [Abstract]
Less than 12 months	(22)	(9)
12 months or longer	(31)	0
Total	$ (53)	$ (9)
Fixed maturities available-for-sale, number of securities [Abstract]
Less than 12 months | Security	4	1
12 months or longer | Security	1	0
Total | Security	5	1
U.S. Treasury Securities and Obligations of U.S. Government Instrumentalities [Member]
Fixed-maturities available-for-sale, estimated fair value [Abstract]
Less than 12 months	$ 983
12 months or longer	0
Total	983
Fixed maturities available-for-sale, gross unrealized loss [Abstract]
Less than 12 months	(4)
12 months or longer	0
Total	$ (4)
Fixed maturities available-for-sale, number of securities [Abstract]
Less than 12 months | Security	1
12 months or longer | Security	0
Total | Security	1
Municipal Securities [Member]
Fixed-maturities available-for-sale, estimated fair value [Abstract]
Less than 12 months	$ 70,535
12 months or longer	0
Total	70,535
Fixed maturities available-for-sale, gross unrealized loss [Abstract]
Less than 12 months	(853)
12 months or longer	0
Total	$ (853)
Fixed maturities available-for-sale, number of securities [Abstract]
Less than 12 months | Security	16
12 months or longer | Security	0
Total | Security	16
Corporate Bonds [Member]
Fixed-maturities available-for-sale, estimated fair value [Abstract]
Less than 12 months	$ 3,931
12 months or longer	0
Total	3,931
Fixed maturities available-for-sale, gross unrealized loss [Abstract]
Less than 12 months	(69)
12 months or longer	0
Total	$ (69)
Fixed maturities available-for-sale, number of securities [Abstract]
Less than 12 months | Security	1
12 months or longer | Security	0
Total | Security	1
Residential Mortgage-backed Securities [Member]
Fixed-maturities available-for-sale, estimated fair value [Abstract]
Less than 12 months	$ 48,592	$ 3,624
12 months or longer	0	0
Total	48,592	3,624
Fixed maturities available-for-sale, gross unrealized loss [Abstract]
Less than 12 months	(546)	(57)
12 months or longer	0	0
Total	$ (546)	$ (57)
Fixed maturities available-for-sale, number of securities [Abstract]
Less than 12 months | Security	13	1
12 months or longer | Security	0	0
Total | Security	13	1
Collateralized Mortgage Obligations [Member]
Fixed-maturities available-for-sale, estimated fair value [Abstract]
Less than 12 months		$ 6,060
12 months or longer		0
Total		6,060
Fixed maturities available-for-sale, gross unrealized loss [Abstract]
Less than 12 months		(21)
12 months or longer		0
Total		$ (21)
Fixed maturities available-for-sale, number of securities [Abstract]
Less than 12 months | Security		2
12 months or longer | Security		0
Total | Security		2
Other Invested Assets - Alternative investments [Member]
Alternative investments, estimated fair value [Abstract]
Less than 12 months	$ 2,439	$ 12,584
12 months or longer	18,022	16,396
Total	20,461	28,980
Alternative investments, gross unrealized loss [Abstract]
Less than 12 months	(105)	(808)
12 months or longer	(3,558)	(2,577)
Total	$ (3,663)	$ (3,385)
Alternative investments, number of securities [Abstract]
Less than 12 months | Security	2	4
12 months or longer | Security	7	6
Total | Security	9	10

Investment in Securities, Matur

Investment in Securities, Maturities of Investment Securities (Details) - USD ($) $ in Thousands	Sep. 30, 2021	Dec. 31, 2020
Fixed maturities available-for-sale, amortized cost [Abstract]
Due in one year or less	$ 60,380
Due after one year through five years	572,854
Due after five years through ten years	149,432
Due after ten years	132,034
Amortized cost	1,204,746	$ 1,227,422
Fixed maturities available-for-sale, estimated fair value [Abstract]
Due in one year or less	61,218
Due after one year through five	605,722
Due after five years through ten years	157,360
Due after ten years	159,190
Estimated fair value	1,290,234	1,342,465
Fixed maturities held-to-maturity, amortized cost [Abstract]
Due in one year or less	1,093
Due after ten years	613
Amortized cost	1,870	1,867
Fixed maturities held-to-maturity, estimated fair value [Abstract]
Due in one year or less	1,093
Due after ten years	767
Estimated fair value	2,032	2,085
Federal Home Loan Bank of New York [Member]
Fixed maturities held-to-maturity, estimated fair value [Abstract]
Amortized cost of investments pledged to secure short term borrowings	207,890	227,890
Fair value of investments pledged to secure short term borrowings	223,930	250,088
Residential Mortgage-backed Securities [Member]
Fixed maturities available-for-sale, amortized cost [Abstract]
Without single maturity date	284,745
Amortized cost	284,745	249,801
Fixed maturities available-for-sale, estimated fair value [Abstract]
Without single maturity date	301,006
Estimated fair value	301,006	271,231
Fixed maturities held-to-maturity, amortized cost [Abstract]
Without single maturity date	164
Amortized cost	164	164
Fixed maturities held-to-maturity, estimated fair value [Abstract]
Without single maturity date	172
Estimated fair value	172	181
Collateralized Mortgage Obligations [Member]
Fixed maturities available-for-sale, amortized cost [Abstract]
Without single maturity date	5,301
Amortized cost	5,301	12,954
Fixed maturities available-for-sale, estimated fair value [Abstract]
Without single maturity date	5,738
Estimated fair value	$ 5,738	$ 13,571

Realized and Unrealized Gains_3

Realized and Unrealized Gains (Losses) (Details) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2021USD ($)Investment	Sep. 30, 2020USD ($)	Sep. 30, 2021USD ($)Investment	Sep. 30, 2020USD ($)	Dec. 31, 2020Investment
Fixed-maturities available-for-sale [Abstract]
Gross gains	$ 0	$ 402	$ 90	$ 1,953
Gross losses	(138)	(1)	(1,104)	(7)
Total fixed-maturity securities	(138)	401	(1,014)	1,946
Equity investments [Abstract]
Gross gains	238	67	2,121	1,057
Gross losses	(19)	(479)	(438)	(3,249)
Gross losses from impaired securities	0	0	0	(678)
Total equity investments	219	(412)	1,683	(2,870)
Other invested assets [Abstract]
Gross gains	934	518	3,077	744
Total other invested assets	934	518	3,077	744
Net realized gains (losses) on securities	1,015	507	3,746	(180)
Recognized in accumulated other comprehensive income (loss) [Abstract]
Unrealized gains (losses)	394	6,203	(18,044)	42,243
Not recognized in the consolidated financial statements [Abstract]
Fixed-maturities-held-to-maturity	(11)	(6)	(56)	64
Deferred tax asset (liability) on unrealized gains (losses)	$ 3,212	8,446	$ 3,212	8,446
Number of individual investment in securities exceeding 10% of stockholders' equity | Investment	0		0		0
Fixed-Maturities Available-for-Sale [Member]
Recognized in accumulated other comprehensive income (loss) [Abstract]
Unrealized gains (losses)	$ (3,742)	4,705	$ (29,555)	44,943
Other Invested Assets [Member]
Recognized in accumulated other comprehensive income (loss) [Abstract]
Unrealized gains (losses)	$ 4,136	$ 1,498	$ 11,511	$ (2,700)

Premiums and Other Receivable_3

Premiums and Other Receivables, Net (Details) - USD ($) $ in Thousands	Sep. 30, 2021	Dec. 31, 2020
Premiums and Other Receivables, Net [Abstract]
Premiums	$ 177,298	$ 106,322
Self-funded group receivables	27,767	26,412
FEHBP	15,002	12,830
Agent balances	30,235	31,509
Accrued interest	9,206	10,418
Reinsurance recoverable	157,665	216,314
Other	128,988	135,774
Premiums and other receivables, total	546,161	539,579
Less allowance for doubtful receivables [Abstract]
Premiums	34,433	37,231
Other	15,251	13,508
Premiums and other receivables, allowance	49,684	50,739
Total premium and other receivables, net	496,477	488,840
Property and Casualty Insurance [Member]
Premiums and Other Receivables, Net [Abstract]
Reinsurance recoverable	115,160	172,021
Government of Puerto Rico [Member]
Premiums and Other Receivables, Net [Abstract]
Premiums and other receivables, total	70,372	53,397
Less allowance for doubtful receivables [Abstract]
Premiums and other receivables, allowance	$ 20,164	$ 23,752

Fair Value Measurements, Fair V

Fair Value Measurements, Fair Value Measurements by Level for Assets Measured at Fair Value on a Recurring Basis (Details) - USD ($) $ in Thousands	Sep. 30, 2021	Dec. 31, 2020
Fair value measurements by level for assets measured at fair value on a recurring basis [Abstract]
Fixed-maturities available-for-sale	$ 1,290,234	$ 1,342,465
Equity investments	518,765	404,328
Obligations of Government-sponsored Enterprises [Member]
Fair value measurements by level for assets measured at fair value on a recurring basis [Abstract]
Fixed-maturities available-for-sale	21,544	25,152
U.S. Treasury Securities and Obligations of U.S. Government Instrumentalities [Member]
Fair value measurements by level for assets measured at fair value on a recurring basis [Abstract]
Fixed-maturities available-for-sale	109,909	111,687
Municipal Securities [Member]
Fair value measurements by level for assets measured at fair value on a recurring basis [Abstract]
Fixed-maturities available-for-sale	650,956	701,028
Corporate Bonds [Member]
Fair value measurements by level for assets measured at fair value on a recurring basis [Abstract]
Fixed-maturities available-for-sale	201,081	219,796
Residential Agency Mortgage-backed Securities [Member]
Fair value measurements by level for assets measured at fair value on a recurring basis [Abstract]
Fixed-maturities available-for-sale	301,006	271,231
Collateralized Mortgage Obligations [Member]
Fair value measurements by level for assets measured at fair value on a recurring basis [Abstract]
Fixed-maturities available-for-sale	5,738	13,571
Fair Value, Measurements, Recurring [Member]
Fair value measurements by level for assets measured at fair value on a recurring basis [Abstract]
Fixed-maturities available-for-sale	1,290,234	1,342,465
Equity investments	518,765	404,328
Fair Value, Measurements, Recurring [Member] | Level 1 [Member]
Fair value measurements by level for assets measured at fair value on a recurring basis [Abstract]
Fixed-maturities available-for-sale	109,909	111,687
Equity investments	276,531	220,118
Fair Value, Measurements, Recurring [Member] | Level 2 [Member]
Fair value measurements by level for assets measured at fair value on a recurring basis [Abstract]
Fixed-maturities available-for-sale	1,180,325	1,230,778
Equity investments	236,893	179,108
Fair Value, Measurements, Recurring [Member] | Level 3 [Member]
Fair value measurements by level for assets measured at fair value on a recurring basis [Abstract]
Fixed-maturities available-for-sale	0	0
Equity investments	5,341	5,102
Fair Value, Measurements, Recurring [Member] | Obligations of Government-sponsored Enterprises [Member]
Fair value measurements by level for assets measured at fair value on a recurring basis [Abstract]
Fixed-maturities available-for-sale	21,544	25,152
Fair Value, Measurements, Recurring [Member] | Obligations of Government-sponsored Enterprises [Member] | Level 1 [Member]
Fair value measurements by level for assets measured at fair value on a recurring basis [Abstract]
Fixed-maturities available-for-sale	0	0
Fair Value, Measurements, Recurring [Member] | Obligations of Government-sponsored Enterprises [Member] | Level 2 [Member]
Fair value measurements by level for assets measured at fair value on a recurring basis [Abstract]
Fixed-maturities available-for-sale	21,544	25,152
Fair Value, Measurements, Recurring [Member] | Obligations of Government-sponsored Enterprises [Member] | Level 3 [Member]
Fair value measurements by level for assets measured at fair value on a recurring basis [Abstract]
Fixed-maturities available-for-sale	0	0
Fair Value, Measurements, Recurring [Member] | U.S. Treasury Securities and Obligations of U.S. Government Instrumentalities [Member]
Fair value measurements by level for assets measured at fair value on a recurring basis [Abstract]
Fixed-maturities available-for-sale	109,909	111,687
Fair Value, Measurements, Recurring [Member] | U.S. Treasury Securities and Obligations of U.S. Government Instrumentalities [Member] | Level 1 [Member]
Fair value measurements by level for assets measured at fair value on a recurring basis [Abstract]
Fixed-maturities available-for-sale	109,909	111,687
Fair Value, Measurements, Recurring [Member] | U.S. Treasury Securities and Obligations of U.S. Government Instrumentalities [Member] | Level 2 [Member]
Fair value measurements by level for assets measured at fair value on a recurring basis [Abstract]
Fixed-maturities available-for-sale	0	0
Fair Value, Measurements, Recurring [Member] | U.S. Treasury Securities and Obligations of U.S. Government Instrumentalities [Member] | Level 3 [Member]
Fair value measurements by level for assets measured at fair value on a recurring basis [Abstract]
Fixed-maturities available-for-sale	0	0
Fair Value, Measurements, Recurring [Member] | Municipal Securities [Member]
Fair value measurements by level for assets measured at fair value on a recurring basis [Abstract]
Fixed-maturities available-for-sale	650,956	701,028
Fair Value, Measurements, Recurring [Member] | Municipal Securities [Member] | Level 1 [Member]
Fair value measurements by level for assets measured at fair value on a recurring basis [Abstract]
Fixed-maturities available-for-sale	0	0
Fair Value, Measurements, Recurring [Member] | Municipal Securities [Member] | Level 2 [Member]
Fair value measurements by level for assets measured at fair value on a recurring basis [Abstract]
Fixed-maturities available-for-sale	650,956	701,028
Fair Value, Measurements, Recurring [Member] | Municipal Securities [Member] | Level 3 [Member]
Fair value measurements by level for assets measured at fair value on a recurring basis [Abstract]
Fixed-maturities available-for-sale	0	0
Fair Value, Measurements, Recurring [Member] | Corporate Bonds [Member]
Fair value measurements by level for assets measured at fair value on a recurring basis [Abstract]
Fixed-maturities available-for-sale	201,081	219,796
Fair Value, Measurements, Recurring [Member] | Corporate Bonds [Member] | Level 1 [Member]
Fair value measurements by level for assets measured at fair value on a recurring basis [Abstract]
Fixed-maturities available-for-sale	0	0
Fair Value, Measurements, Recurring [Member] | Corporate Bonds [Member] | Level 2 [Member]
Fair value measurements by level for assets measured at fair value on a recurring basis [Abstract]
Fixed-maturities available-for-sale	201,081	219,796
Fair Value, Measurements, Recurring [Member] | Corporate Bonds [Member] | Level 3 [Member]
Fair value measurements by level for assets measured at fair value on a recurring basis [Abstract]
Fixed-maturities available-for-sale	0	0
Fair Value, Measurements, Recurring [Member] | Residential Agency Mortgage-backed Securities [Member]
Fair value measurements by level for assets measured at fair value on a recurring basis [Abstract]
Fixed-maturities available-for-sale	301,006	271,231
Fair Value, Measurements, Recurring [Member] | Residential Agency Mortgage-backed Securities [Member] | Level 1 [Member]
Fair value measurements by level for assets measured at fair value on a recurring basis [Abstract]
Fixed-maturities available-for-sale	0	0
Fair Value, Measurements, Recurring [Member] | Residential Agency Mortgage-backed Securities [Member] | Level 2 [Member]
Fair value measurements by level for assets measured at fair value on a recurring basis [Abstract]
Fixed-maturities available-for-sale	301,006	271,231
Fair Value, Measurements, Recurring [Member] | Residential Agency Mortgage-backed Securities [Member] | Level 3 [Member]
Fair value measurements by level for assets measured at fair value on a recurring basis [Abstract]
Fixed-maturities available-for-sale	0	0
Fair Value, Measurements, Recurring [Member] | Collateralized Mortgage Obligations [Member]
Fair value measurements by level for assets measured at fair value on a recurring basis [Abstract]
Fixed-maturities available-for-sale	5,738	13,571
Fair Value, Measurements, Recurring [Member] | Collateralized Mortgage Obligations [Member] | Level 1 [Member]
Fair value measurements by level for assets measured at fair value on a recurring basis [Abstract]
Fixed-maturities available-for-sale	0	0
Fair Value, Measurements, Recurring [Member] | Collateralized Mortgage Obligations [Member] | Level 2 [Member]
Fair value measurements by level for assets measured at fair value on a recurring basis [Abstract]
Fixed-maturities available-for-sale	5,738	13,571
Fair Value, Measurements, Recurring [Member] | Collateralized Mortgage Obligations [Member] | Level 3 [Member]
Fair value measurements by level for assets measured at fair value on a recurring basis [Abstract]
Fixed-maturities available-for-sale	$ 0	$ 0

Fair Value Measurements, Reconc

Fair Value Measurements, Reconciliation of Assets Measured at Fair Value Using Significant Unobservable Inputs (Level 3) (Details) - USD ($) $ in Thousands	3 Months Ended	9 Months Ended
	Sep. 30, 2021	Sep. 30, 2021	Dec. 31, 2020
Fair Value Measurements [Abstract]
Level 1 to level 2 transfers	$ 0	$ 0	$ 0
Level 2 to level 1 transfers	0	0	$ 0
Reconciliation of beginning and ending balances of assets measured at fair value on a recurring basis using significant unobservable inputs (Level 3) [Roll Forward]
Beginning Balance	5,199	5,102
Unrealized in other accumulated comprehensive income	142	239
Ending Balance	$ 5,341	$ 5,341

Claim Liabilities, Reconciliati

Claim Liabilities, Reconciliation of Beginning and Ending Balances of Claim Liabilities (Details) - USD ($) $ in Thousands		3 Months Ended		9 Months Ended
		Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Reconciliation of beginning and ending balances of claim liabilities [Roll Forward]
Claim liabilities at beginning of period				$ 787,102	$ 709,258
Reinsurance recoverable on claim liabilities				(138,816)	(137,017)
Net claim liabilities at beginning of period				648,286	572,241
Claims incurred [Abstract]
Current period insured events				2,577,621	2,085,183
Prior period insured events				(35,004)	16,412
Total				2,542,617	2,101,595
Payments of losses and loss-adjustment expenses [Abstract]
Current period insured events				2,172,036	1,724,215
Prior period insured events				299,491	308,508
Total				2,471,527	2,032,723
Net claim liabilities at end of period		$ 719,376	$ 641,113	719,376	641,113
Reinsurance recoverable on claim liabilities		79,132	145,807	79,132	145,807
Claim liabilities at end of period		798,508	786,920	798,508	786,920
Change in liability for future policy (benefits) expense		9,539	13,737	30,952	27,806
Other Business Segments [Member]
Reconciliation of beginning and ending balances of claim liabilities [Roll Forward]
Claim liabilities at beginning of period	[1]			341,447	367,981
Reinsurance recoverable on claim liabilities	[1]			(138,816)	(137,017)
Net claim liabilities at beginning of period	[1]			202,631	230,964
Claims incurred [Abstract]
Current period insured events	[1]			92,526	84,358
Prior period insured events	[1]			982	(7,885)
Total	[1]			93,508	76,473
Payments of losses and loss-adjustment expenses [Abstract]
Current period insured events	[1]			47,360	45,815
Prior period insured events	[1]			63,086	41,081
Total	[1]			110,446	86,896
Net claim liabilities at end of period	[1]	185,693	220,541	185,693	220,541
Reinsurance recoverable on claim liabilities	[1]	79,132	145,807	79,132	145,807
Claim liabilities at end of period	[1]	264,825	366,348	264,825	366,348
Managed Care [Member]
Reconciliation of beginning and ending balances of claim liabilities [Roll Forward]
Claim liabilities at beginning of period				445,655	341,277
Reinsurance recoverable on claim liabilities				0	0
Net claim liabilities at beginning of period				445,655	341,277
Claims incurred [Abstract]
Current period insured events				2,485,095	2,000,825
Prior period insured events				(35,986)	24,297
Total				2,449,109	2,025,122
Payments of losses and loss-adjustment expenses [Abstract]
Current period insured events				2,124,676	1,678,400
Prior period insured events				236,405	267,427
Total				2,361,081	1,945,827
Net claim liabilities at end of period		533,683	420,572	533,683	420,572
Reinsurance recoverable on claim liabilities		0	0	0	0
Claim liabilities at end of period		$ 533,683	$ 420,572	$ 533,683	$ 420,572
[1]	Other Business Segments include the Life Insurance and Property and Casualty segments, as well as intersegment eliminations.

Claim Liabilities, Total Incurr

Claim Liabilities, Total Incurred But Not Reported Liabilities Plus Expected Development on Reported Claims Included in Net Incurred Claims Amounts (Details) - Managed Care [Member] $ in Thousands	Sep. 30, 2021USD ($)
Incurred Year 2020 [Member]
Insurance Claims Development, Net of Reinsurance [Abstract]
Total of IBNR liabilities plus expected development on reported claims	$ 119,675
Incurred Year 2021 [Member]
Insurance Claims Development, Net of Reinsurance [Abstract]
Total of IBNR liabilities plus expected development on reported claims	$ 360,419

Borrowings (Details)

Borrowings (Details) $ in Thousands	9 Months Ended
	Sep. 30, 2021USD ($)Loan	Dec. 31, 2020USD ($)
Borrowings [Abstract]
Maximum borrowing capacity	$ 192,430	$ 200,338
Outstanding balance	$ 0	$ 30,000
Average interest rate of outstanding balance		0.33%
TSS [Member] | Maximum [Member]
Borrowings [Abstract]
Borrowing capacity of admitted assets percentage	15.00%
TSV [Member] | Maximum [Member]
Borrowings [Abstract]
Borrowing capacity of admitted assets percentage	10.00%
Commercial Bank in Puerto Rico [Member]
Borrowings [Abstract]
Number of term loans not in compliance with Debt Service Coverage Ratio covenant | Loan	3
Term loans, outstanding balance	$ 20,217	$ 22,644
Commercial Bank in Puerto Rico [Member] | TSA [Member]
Borrowings [Abstract]
Maximum borrowing capacity	10,000
Outstanding balance	$ 0
Expiration date	Jun. 30, 2021
Commercial Bank in Puerto Rico [Member] | TSA [Member] | LIBOR [Member]
Borrowings [Abstract]
Variable rate, term	30 days
Basis spread on variable rate	2.50%

Pension Plan (Details)

Pension Plan (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020	Dec. 31, 2020
Components of net periodic benefit cost [Abstract]
Interest cost	$ 1,370	$ 1,474	$ 4,120	$ 4,554
Expected return on assets	(1,098)	(2,211)	(3,298)	(6,629)
Amortization of actuarial loss	994	396	2,944	884
Settlement loss	1,359	356	3,359	1,068
Net periodic benefit cost (income)	$ 2,625	$ 15	7,125	$ (123)
Expected employer future contributions					$ 10,000
Employer contribution			$ 10,000

Reinsurance (Details)

Reinsurance (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Reinsurance [Abstract]
Period of reinsurance contracts			1 year
TSP [Member]
Reinsurance [Abstract]
Ceded premiums written	$ 14,791	$ 14,920	$ 44,245	$ 45,637
Ceded incurred loss adjustment expenses	$ 3,926	$ 5,419	3,167	45,802
TSP [Member] | Catastrophe [Member]
Reinsurance [Abstract]
Claims ceded				$ 40,000
Maximum amount of claim to be covered, per person			811,450
Amount of claim covered after retention			816,450
TSP [Member] | Minimum [Member] | Casualty Excess of Loss Treaty [Member]
Reinsurance [Abstract]
Amount of claim covered, per person			225
TSP [Member] | Minimum [Member] | Medical Malpractice Excess of Loss [Member]
Reinsurance [Abstract]
Amount of claim covered, per person			150
TSP [Member] | Minimum [Member] | Property Reinsurance Treaty [Member]
Reinsurance [Abstract]
Amount of claim covered, per person			400
TSP [Member] | Minimum [Member] | Catastrophe [Member]
Reinsurance [Abstract]
Amount of claim covered, per person			5,000
TSP [Member] | Maximum [Member] | Casualty Excess of Loss Treaty [Member]
Reinsurance [Abstract]
Amount of claim covered, per person			20,000
TSP [Member] | Maximum [Member] | Medical Malpractice Excess of Loss [Member]
Reinsurance [Abstract]
Amount of claim covered, per person			3,000
TSP [Member] | Maximum [Member] | Property Reinsurance Treaty [Member]
Reinsurance [Abstract]
Amount of claim covered, per person			$ 30,000

Comprehensive Income (Loss) (De

Comprehensive Income (Loss) (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Accumulated balances for each classification of other comprehensive income, net of tax [Roll Forward]
Balance	$ 1,004,753	$ 979,535	$ 967,513	$ 943,172
Total other comprehensive income (loss), net of tax	1,042	4,990	(12,030)	32,576
Balance	1,016,941	1,009,687	1,016,941	1,009,687
Net Unrealized Gain on Securities [Member]
Accumulated balances for each classification of other comprehensive income, net of tax [Roll Forward]
Balance	77,399	85,110	91,689	57,830
Other comprehensive income (loss) before reclassifications	1,233	5,149	(10,872)	31,879
Amounts reclassified from accumulated other comprehensive (loss) income	(812)	(406)	(2,997)	144
Total other comprehensive income (loss), net of tax	421	4,743	(13,869)	32,023
Balance	77,820	89,853	77,820	89,853
Liability for Pension Benefits [Member]
Accumulated balances for each classification of other comprehensive income, net of tax [Roll Forward]
Balance	(100,291)	(28,161)	(101,509)	(28,467)
Amounts reclassified from accumulated other comprehensive (loss) income	621	247	1,839	553
Balance	(99,670)	(27,914)	(99,670)	(27,914)
Accumulated Other Comprehensive (Loss) Income [Member]
Accumulated balances for each classification of other comprehensive income, net of tax [Roll Forward]
Balance	(22,892)	56,949	(9,820)	29,363
Other comprehensive income (loss) before reclassifications	1,233	5,149	(10,872)	31,879
Amounts reclassified from accumulated other comprehensive (loss) income	(191)	(159)	(1,158)	697
Total other comprehensive income (loss), net of tax	1,042	4,990	(12,030)	32,576
Balance	$ (21,850)	$ 61,939	$ (21,850)	$ 61,939

Share-Based Compensation (Detai

Share-Based Compensation (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Share-Based Compensation [Abstract]
Share-based compensation expense	$ 3,031	$ 1,849	$ 6,964	$ 8,443
Shares repurchased and retired as a result of non-cash tax withholdings upon vesting of shares (in shares)	2,063	14,040	22,886	20,922

Net Income Available to Stock_3

Net Income Available to Stockholders and Net Income per Share (Details) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Numerator for earnings per share [Abstract]
Net income attributable to TSM available to stockholders	$ 8,167	$ 23,581	$ 55,037	$ 41,035
Denominator for basic earnings per share [Abstract]
Weighted average of common shares (in shares)	23,494,415	23,073,511	23,402,622	23,215,840
Effect of dilutive securities (in shares)	116,257	120,469	143,655	102,229
Denominator for diluted earnings per share (in shares)	23,610,672	23,193,980	23,546,277	23,318,069
Basic net income per share attributable to TSM (in dollars per share)	$ 0.35	$ 1.02	$ 2.35	$ 1.77
Diluted net income per share attributable to TSM (in dollars per share)	$ 0.35	$ 1.02	$ 2.34	$ 1.76

Contingencies (Details)

Contingencies (Details) - USD ($) $ in Thousands	Sep. 30, 2021	Dec. 31, 2020
Minimum [Member]
Contingencies [Abstract]
Loss contingency, possible losses	$ 0
Maximum [Member]
Contingencies [Abstract]
Loss contingency, possible losses	10,000
In re Blue Cross Blue Shield Antitrust Litigation [Member]
Contingencies [Abstract]
Accrued liability related to legal proceedings	$ 27,364	$ 32,000

Segment Information (Details)

Segment Information (Details) $ in Thousands		3 Months Ended		9 Months Ended
		Sep. 30, 2021USD ($)	Sep. 30, 2020USD ($)	Sep. 30, 2021USD ($)Segment	Sep. 30, 2020USD ($)	Dec. 31, 2020USD ($)
Segment Information [Abstract]
Number of operating segments | Segment				3
Operating revenues [Abstract]
Premiums earned, net		$ 1,019,696	$ 922,934	$ 3,016,012	$ 2,657,366
Administrative service fees		3,875	3,752	9,316	8,755
Net investment income		17,572	14,168	46,178	42,294
Consolidated operating revenues		1,045,068	942,906	3,080,024	2,714,809
Operating income (loss) [Abstract]
Consolidated operating income		11,595	22,305	49,575	85,739
Consolidated net realized investment gains (losses)		1,015	507	3,746	(180)
Consolidated net unrealized investment (losses) gains on equity investments		(7,912)	11,040	13,383	(17,428)
Consolidated interest expense		(2,016)	(2,096)	(6,225)	(5,813)
Consolidated other income, net		11,085	1,811	19,047	6,217
Consolidated income before taxes		13,767	33,567	79,526	68,535
Depreciation and amortization expense [Abstract]
Depreciation and amortization expense		3,554	3,111	10,667	10,855
Assets [Abstract]
Assets		3,191,666		3,191,666		$ 3,088,418
Cash, cash equivalents, and investments		2,063,454		2,063,454		1,985,013
Property and equipment, net		137,762		137,762		131,974
Other assets		99,143		99,143		86,118
Other Segments [Member]
Operating revenues [Abstract]
TSM operating revenues from external sources	[1]	3,925	2,052	8,518	6,394
Consolidated operating revenues	[1]	6,154	4,647	18,196	14,031
Operating income (loss) [Abstract]
Operating income (loss)	[1]	(2,161)	(1,639)	(6,593)	(4,552)
TSM operating revenues from external sources	[1]	3,925	2,052	8,518	6,394
Depreciation and amortization expense [Abstract]
Depreciation and amortization expense	[1]	355	240	1,057	913
Assets [Abstract]
Assets	[1]	35,854		35,854		34,020
Reportable Segment [Member]
Operating revenues [Abstract]
Consolidated operating revenues		1,048,554	945,975	3,093,900	2,726,727
Operating income (loss) [Abstract]
Operating income (loss)		13,937	21,435	53,438	83,052
Depreciation and amortization expense [Abstract]
Depreciation and amortization expense		3,066	2,707	9,349	10,139
Assets [Abstract]
Assets		3,097,231		3,097,231		2,988,632
Reportable Segment [Member] | Managed Care [Member]
Operating revenues [Abstract]
Premiums earned, net		939,210	849,529	2,779,869	2,447,588
Administrative service fees		3,875	3,013	9,316	8,755
Net investment income		8,088	5,065	19,088	14,763
Consolidated operating revenues		951,771	858,251	2,810,592	2,473,730
Operating income (loss) [Abstract]
Operating income (loss)		8,532	13,006	34,496	56,495
Depreciation and amortization expense [Abstract]
Depreciation and amortization expense		2,319	2,085	7,111	8,061
Assets [Abstract]
Assets		1,456,710		1,456,710		1,319,389
Reportable Segment [Member] | Life Insurance [Member]
Operating revenues [Abstract]
Premiums earned, net		54,394	49,616	159,783	143,325
Net investment income		6,785	6,900	19,851	20,625
Consolidated operating revenues		61,815	57,032	181,445	165,502
Operating income (loss) [Abstract]
Operating income (loss)		5,591	5,682	17,772	20,188
Depreciation and amortization expense [Abstract]
Depreciation and amortization expense		320	289	965	869
Assets [Abstract]
Assets		1,095,884		1,095,884		1,051,819
Reportable Segment [Member] | Property and Casualty Insurance [Member]
Operating revenues [Abstract]
Premiums earned, net		26,092	23,789	76,360	66,453
Net investment income		2,569	2,103	6,847	6,551
Consolidated operating revenues		28,814	26,045	83,667	73,464
Operating income (loss) [Abstract]
Operating income (loss)		1,975	4,386	7,763	10,921
Depreciation and amortization expense [Abstract]
Depreciation and amortization expense		72	93	216	296
Assets [Abstract]
Assets		508,783		508,783		583,404
Unallocated Amount to Segment [Member]
Operating revenues [Abstract]
TSM operating revenues from external sources		130	100	392	355
Operating income (loss) [Abstract]
TSM operating revenues from external sources		130	100	392	355
TSM unallocated operating expenses		(4,875)	(1,633)	(11,464)	(4,877)
Depreciation and amortization expense [Abstract]
Depreciation and amortization expense		488	404	1,318	716
Assets [Abstract]
Assets		181,411		181,411		173,851
Cash, cash equivalents, and investments		16,945		16,945		16,489
Property and equipment, net		74,209		74,209		68,678
Other assets		90,257		90,257		88,684
Intersegment Elimination [Member]
Operating revenues [Abstract]
Premiums earned, net		(1,387)	(574)	(4,590)	(4,636)
Consolidated operating revenues		(2,229)	(2,595)	(9,678)	(7,637)
Operating income (loss) [Abstract]
Elimination of TSM intersegment charges		2,403	2,403	7,209	7,209
Assets [Abstract]
Assets		(86,976)		(86,976)		$ (74,065)
Intersegment Elimination [Member] | Managed Care [Member]
Operating revenues [Abstract]
Premiums earned, net		598	644	2,319	2,624
Intersegment Elimination [Member] | Life Insurance [Member]
Operating revenues [Abstract]
Premiums earned, net		636	516	1,811	1,552
Intersegment Elimination [Member] | Property and Casualty Insurance [Member]
Operating revenues [Abstract]
Premiums earned, net		153	153	460	460
Intersegment Elimination [Member] | Other Segments [Member]
Operating revenues [Abstract]
Consolidated operating revenues	[1]	$ 2,229	$ 2,595	$ 9,678	$ 7,637
[1]	Includes segments that are not required to be reported separately, primarily the health clinics.