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 Triple-S Management Corporation Reports Fourth Quarter 2017 Results
   Thursday, March 01, 2018 6:00:00 AM ET

Triple-S Management Corporation (GTS ), a leading managed care company in Puerto Rico, today announced its fourth quarter 2017 results.

Quarterly Consolidated and Other Highlights and Subsequent Events

-- Net income of $24.2 million, or $1.03 per diluted share, versus net income of $12.0 million, or $0.50 per diluted share, in the prior-year period;

-- Adjusted net income of $22.1 million, or $0.94 per diluted share, versus adjusted net income of $3.4 million, or $0.14 per diluted share, a year ago, reflecting the ongoing improvements in the Company’s Managed Care operations and the estimated decrease in utilization of medical services caused by Hurricanes Irma and Maria. The net impact of the recent hurricanes represented approximately $0.46 of the improvement in the quarter’s adjusted earnings per share;

-- Operating revenues of $706.8 million, a 1.7% decrease from the prior-year period, reflecting lower premiums in the Property & Casualty and Managed Care segments;

-- Consolidated operating income of $41.1 million compared to an operating loss of $1.5 million in the prior-year period;

-- Consolidated loss ratio of 78.2%, driven primarily by lower utilization in Managed Care with a medical loss ratio ("MLR") of 80.9%;

-- The Company’s Board authorized a $25.0 million expansion of its existing $30.0 million Class B share repurchase program. Under the repurchase program, during the fourth quarter of 2017, 322,381 shares were repurchased at an aggregate cost of $7.7 million. Thus far during 2018, the Company has repurchased an additional 225,000 shares at an aggregate cost of $5.3 million. As of February 27, 2018, including the expansion, $29.4 million of capacity remain in the program.

"Our fourth quarter results benefited from lower claims in Managed Care due primarily to the aftereffects of Hurricane Maria, but was also characterized by continued progress of the ongoing initiatives in our Managed Care operations," said Roberto Garcia-Rodriguez, President and Chief Executive Officer. "We have made significant improvements to our technology, claims processing and clinical operations. As a result of our expanded relationship with Optum, we expect to further improve our infrastructure throughout 2018, which should ultimately provide our customers with upgraded service while allowing us to achieve additional efficiencies and make our products more competitive and attractive over the long-term."

"There has been significant progress with respect to Puerto Rico’s recovery from the hurricanes over the past few months," continued Mr. Garcia-Rodriguez. "As of late February, potable water was at 99% of capacity, power generation stood at 84% of average, and telecommunications bandwidth has been essentially repaired throughout the island. While there is still work left to return all Puerto Ricans to some sense of normalcy, we believe Puerto Rico is much closer to being fully operational once again and we continue to closely work hand-in-hand with our providers to ensure they are fully functional. We have also been encouraged by the recent Congressional action to support the hurricane recovery with $16 billion in overall federal funding and address the Island’s Medicaid cliff with $4.8 billion and a 2-year 100% FMAP federal contribution."

"Although our providers continue to face certain operational challenges, the vast majority of healthcare services now up and running, so it has been back to the normal course of business for Triple-S over the past couple of months," added Mr. Garcia-Rodriguez. "Looking into 2018, as Puerto Rico’s infrastructure is rebuilt, we continue to take the steps necessary to stand out as the preeminent healthcare company in Puerto Rico, ensure that our Managed Care business once again drives our bottom line and create long-term value for our shareholders."

Selected Consolidated Quarterly Details

-- Consolidated premiums earned were $687.4 million, down 2.1% from the prior-year period. The decrease reflects lower premiums in the Managed Care segment, primarily due to the profit sharing accrual recorded in 2016 in the Medicaid business and the suspension of the HIP fee pass-through, as well as approximately $6.2 million of estimated reinsurance related costs in the Company’s Property and Casualty segment, including estimates for catastrophe reinsurance reinstatement costs for the remainder of 2017. The decrease was partially offset by higher average premium rates in the Managed Care segment’s Commercial and Medicaid businesses.

-- Consolidated claims incurred were $537.3 million, down 9.6% year over year, mostly due to lower claims incurred across all businesses in the Managed Care segment, driven mainly by favorable fluctuations in prior-period reserve developments, the ongoing improvements in the Company’s Managed Care operations and the utilization decrease caused by Hurricanes Irma and Maria. Consolidated loss ratio of 78.2% improved 650 basis points from the prior-year period.

-- Consolidated operating expenses of $128.4 million increased 1.6% from the prior-year period, while the operating expense ratio increased 70 basis points year over year to 18.6%. The increase in operating expenses reflects higher personnel costs, business promotion and hurricane-related expenses totaling approximately $12.8 million, partially offset by an $11.1 million decrease in the HIP fee due to the 2017 moratorium.

-- Consolidated income tax expense was $17.9 million, an increase of $21.8 million from the prior-year period, primarily reflecting a significant increase in the Managed Care segment’s taxable income, which has a higher effective tax rate than the Company’s other segments.

-- As of December 31, 2017, the consolidated balance sheet reflects approximately $605 million within claim liabilities of unpaid estimated gross losses related to the hurricanes, as well as $613 million within premiums and other receivables of catastrophe-related losses recoverable from the Property and Casualty reinsurance program.

Selected Managed Care Segment Quarterly Details

-- Managed Care premiums earned were $633.8 million, down 0.9% year over year.

-- Commercial premiums of $195.9 million declined 4.3% from the prior-year period, due to lower fully-insured member month enrollment and the suspension of $3.6 million in the HIP fee pass-through in 2017, partially offset by higher average premium rates.

-- Medicare premiums of $246.8 million increased 5.2% year over year, largely reflecting an increase in member month enrollment of 28,000 lives, offset, in part, by a $3.8 million decline in additional risk score revenue adjustments and a reduction in Medicare reimbursement rates.

-- Medicaid premiums declined 4.6% from the prior-year period to $191.1 million, primarily reflecting the 2.5% excess profit sharing accrual that increased 2016 premiums by $6.3 million, a membership decline of approximately 45,000 member months, and the suspension of $2.7 million in the HIP fee pass-through in 2017; offset in part by an average premium rate increase of approximately 9% that became effective July 1, 2017, following the Medicaid contract extension.

-- Managed Care MLR of 80.9% improved 710 basis points from the prior year, mostly reflecting the estimated decrease in utilization caused by Hurricanes Irma and Maria and favorable prior-period reserve developments. Excluding the impact of prior-period reserve developments, and moving the Medicare risk score revenue adjustments and other premium adjustments to the corresponding period, the Managed Care MLR would have been 82.5%, 260 basis points lower than the comparable metric a year ago. The estimated decrease in utilization related to the hurricanes lowered the segment’s claims incurred and adjusted MLR by approximately $27 million and 430 basis points, respectively.

-- Managed Care operating expenses were $95.2 million, down $0.7 million, or 0.7%, year over year, primarily reflecting the HIP fee decrease and mostly offset by an increase in personnel costs, hurricane-related expenses, provision for doubtful accounts and other general and administrative expenses, as discussed above.

Consolidated Year-End Recap

Consolidated operating revenues for the year ended December 31, 2017 decreased 2.1% year over year to $2.9 billion, primarily reflecting a $58.5 million decline in Managed Care segment premiums due to lower membership in the segment’s Commercial and Medicaid businesses, the suspension of the HIP fee pass-through, and lower Medicare risk score revenue adjustments. Consolidated claims for the year were $2.4 billion, a 4.8% decline from the prior year, mostly due to lower claims in the Managed Care segment that were partially offset by increased claims in the Property and Casualty segment. The decrease in Managed Care claims primarily reflects lower claims incurred in all of the segment’s businesses, driven by an enrollment decline in the segment’s Commercial and Medicaid businesses and the decrease in utilization caused by the two hurricanes, as well as favorable fluctuations in the prior-period reserve developments in the Commercial and Medicare businesses.

The Property and Casualty segment’s estimated net retained losses related to the hurricanes were approximately $14.8 million after the application of reinsurance. The consolidated loss ratio for 2017 was 83.2%, a 230 basis point improvement primarily driven by an MLR for 2017 of 85.6%, a decline of 300 basis points from the prior year. Consolidated operating expenses for the year ended December 31, 2017 were $477.2 million and the operating expense ratio was 16.8%.

Adjusted net income for full year 2017 was $45.5 million, or $1.89 per diluted share, compared with adjusted net income of $3.2 million, or $0.13 per diluted share, in the prior year.

2018 Outlook

As Puerto Rico continues to rebuild, utilization patterns, outward migration and the impact of reconstruction efforts remain somewhat unclear, and in February, the Puerto Rico government issued a request for proposal that will introduce significant changes to the island’s Medicaid model by the fourth quarter of 2018. Given these market uncertainties, the Company believes it is premature to provide comprehensive full-year guidance at this time. Instead, it is providing full year 2018 directional guidance regarding its Commercial, Medicare Advantage and ancillary businesses, as well as operating expenses.

-- In the Company’s Commercial business, the Company expects full-year at-risk member month enrollment to be between 3.7 million and 3.8 million, and MLR for the full year is expected to be between 80.5% and 82.5%.

-- In the Company’s Medicare Advantage business, the Company anticipates full year member month enrollment to be between 1.35 million and 1.45 million, while MLR for 2018 is expected to be between 85% and 87%.

-- The Company’s ancillary segments are expected to remain stable in terms of premiums earned. Life insurance premiums earned for 2018 are expected to be between $160 million and $164 million, while Property and Casualty premiums earned for 2018 are expected to be between $76 million and $80 million.

-- Operating expenses for full year 2018 are expected to be between $530 million and $545 million, primarily reflecting the reinstatement of the HIP fee.

Conference Call and Webcast

Management will host a conference call and webcast today at 8:30 a.m. Eastern Time to discuss its financial results for the three months and year ended December 31, 2017. To participate, callers within the U.S. and Canada should dial 1-855-327-6837 and international callers should dial 1-631-891-4304 about five minutes before the call.

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

In addition, a replay will be available through March 15, 2018 by calling 1-844-512-2921 or 1-412-317-6671 and entering passcode 10004194. A replay will also be available at for 30 days.

About Triple-S Management Corporation

Triple-S Management Corporation is an independent licensee of the Blue Cross Blue Shield Association. It is one of the leading players in the managed care industry in Puerto Rico. Triple-S Management has the exclusive right to use the Blue Cross Blue Shield name and mark throughout Puerto Rico, the U.S. Virgin Islands, and Costa Rica. With more than 55 years of experience in the industry, Triple-S Management offers a broad portfolio of managed care and related products in the Commercial, Medicare Advantage, and Medicaid markets under the Blue Cross Blue Shield marks. It also provides non-Blue Cross Blue Shield branded life and property and casualty insurance in Puerto Rico. For more information about Triple-S Management, visit or contact

Non-GAAP Financial Measures

This earnings release presents information about the Company’s adjusted net income, which is a non-GAAP financial metric provided as a complement to the results provided in accordance with accounting principles generally accepted in the United States of America (GAAP). A reconciliation of adjusted net income to net income, the most comparable GAAP financial measure, is provided in the accompanying tables found at the end of this release.

Forward-Looking Statements

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

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

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

-- Trends in health care costs and utilization rates

-- Ability to secure sufficient premium rate increases

-- Competitor pricing below market trends of increasing costs

-- Re-estimates of policy and contract liabilities

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

-- Significant acquisitions or divestitures by major competitors

-- Introduction and use of new prescription drugs and technologies

-- A downgrade in the Company’s financial strength ratings

-- A downgrade in the Government of Puerto Rico’s debt

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

-- Ability to contract with providers consistent with past practice

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

-- Ability to maintain Federal Employees, Medicare and Medicaid contracts

-- Volatility in the securities markets and investment losses and defaults

-- General economic downturns, major disasters, and epidemics

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

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

Earnings Release Schedules and Supplementary Information
Condensed Consolidated Balance Sheets                    Exhibit I
Condensed Consolidated Statements of Earnings            Exhibit II
Condensed Consolidated Statements of Cash Flows          Exhibit III
Segment Performance Supplemental Information             Exhibit IV
Reconciliation of Non-GAAP Financial Measures            Exhibit V
Exhibit I
Condensed Consolidated Balance Sheets
(dollar amounts in thousands)
                                                                                                        December 31,      December 31,
                                                                                                        2017              2016
Investments                                                                                             $      1,605,477  $      1,433,392
Cash and cash equivalents                                                                                      198,941           103,428
Premium and other receivables, net                                                                             899,327           286,365
Deferred policy acquisition costs and value of business acquired                                               200,788           194,787
Property and equipment, net                                                                                    74,716            66,369
Other assets                                                                                                   137,516           134,658
                                            Total assets                                                $      3,116,765  $      2,218,999
Liabilities and Stockholders’ Equity
Policy liabilities and accruals                                                                         $      1,761,553  $      1,102,237
Accounts payable and accrued liabilities                                                                       410,457           219,191
Long-term borrowings                                                                                           32,073            35,085
                                            Total liabilities                                                  2,204,083         1,356,513
Stockholders’ equity:
                      Common stock                                                                             23,578            24,272
                      Other stockholders’ equity                                                               889,786           838,891
                                            Total Triple-S Management Corporation stockholders’ equity         913,364           863,163
Non-controlling interest in consolidated subsidiary                                                            (682)             (677)
Total stockholders’ equity                                                                                     912,682           862,486
Total liabilities and stockholders’ equity                                                              $      3,116,765  $      2,218,999
Exhibit II
Condensed Consolidated Statements of Earnings
(dollar amounts in thousands, except per share data)
                                                                                     For the Three Months Ended          For the Year Ended
                                                                                     December 31,                        December 31,
                                                                                     2017              2016              2017            2016
                       Premiums earned, net                                          $     687,443     $     701,871     $   2,826,932   $   2,890,641
                       Administrative service fees                                         4,196             4,094           16,514          17,843
                       Net investment income                                               14,506            12,343          51,615          48,913
                       Other operating revenues                                            633               863             3,660           3,461
                                                     Total operating revenues              706,778           719,171         2,898,721       2,960,858
Net realized investment gains (losses):
                       Total other-than-temporary impairment losses on securities          (49)              -               (49)            (1,434)
                       Net realized gains, excluding other-than-temporary
                                                     impairment losses on securities       2,737             10,425          10,880          18,813
                       Net realized investment gains on sale of securities                 2,688             10,425          10,831          17,379
                       Other income, net                                                   12                1,101           6,533           6,569
                                                     Total revenues                        709,478           730,697         2,916,085       2,984,806
Benefits and expenses:
                       Claims incurred                                                     537,316           594,241         2,353,101       2,472,191
                       Operating expenses                                                  128,402           126,396         477,213         493,894
                                                     Total operating costs                 665,718           720,637         2,830,314       2,966,085
                       Interest expense                                                    1,678             1,906           6,794           7,635
                                                     Total benefits and expenses           667,396           722,543         2,837,108       2,973,720
                                                     Income before taxes                   42,082            8,154           78,977          11,086
Income tax expense (benefit)                                                               17,874            (3,888)         24,496          (6,345)
Net income                                                                                 24,208            12,042          54,481          17,431
                       Less: Net loss attributable to the non-controlling interest         3                 1               5               7
Net income attributable to Triple-S Management Corporation                           $     24,211      $     12,043      $   54,486      $   17,438
Earnings per share attributable to Triple-S Management Corporation:
                       Basic net income per share                                    $     1.03        $     0.50        $   2.27        $   0.71
                       Diluted net income per share                                  $     1.03        $     0.50        $   2.26        $   0.71
                       Weighted average of common shares                                   23,459,879        24,215,544      23,996,503      24,454,435
                       Dilutive weighted average of common shares                          23,557,197        24,272,286      24,067,586      24,511,093
Exhibit III
Condensed Consolidated Statements of Cash Flows
(dollar amounts in thousands)
                                                                                                                       For the Year Ended
                                                                                                                       December 31,
                                                                                                                       2017            2016
Net cash provided by operating activities                                                                              $    288,918    $    6,471
Cash flows from investing activities:
          Proceeds from investments sold or matured:
                        Securities available for sale:
                                             Fixed maturities sold                                                          463,232         400,848
                                             Fixed maturities matured/called                                                18,893          56,988
                                             Equity securities sold                                                         59,963          109,049
                        Securities held to maturity - fixed maturities matured/called                                       2,712           1,538
          Acquisition of investments:
                        Securities available for sale:
                                             Fixed maturities                                                               (560,304)       (482,252)
                                             Equity securities                                                              (134,834)       (163,119)
                        Securities held to maturity - fixed maturities                                                      (2,197)         (1,445)
          Increase in other investments                                                                                     (2,064)         (2,493)
          Net disbursements for policy loans                                                                                (513)           (663)
          Net capital expenditures                                                                                          (21,359)        (4,750)
                                                                  Net cash used in investing activities                     (176,471)       (86,299)
Cash flows from financing activities:
          Change in outstanding checks in excess of bank balances                                                           12,683          12,250
          Repayments of long-term borrowings                                                                                (2,836)         (1,742)
          Proceeds from revolving line of credit                                                                            1,964           -
          Repurchase and retirement of common stock                                                                         (20,220)        (21,371)
          Proceeds from policyholder deposits                                                                               13,557          18,224
          Surrender of policyholder deposits                                                                                (22,082)        (21,923)
                                                                  Net cash used in financing activities                     (16,934)        (14,562)
                                                                  Net increase (decrease) in cash and cash equivalents      95,513          (94,390)
Cash and cash equivalents, beginning of period                                                                              103,428         197,818
Cash and cash equivalents, end of period                                                                               $    198,941    $    103,428
Exhibit IV
Segment Performance Supplemental Information
(Unaudited)                                                                          Three months ended December 31,           Year ended December 31,
(dollar amounts in millions)                                                         2017          2016           Percentage   2017         2016           Percentage
                                                                                                                  Change                                   Change
Premiums earned, net:
            Managed Care:
                        Commercial                                                   $     195.9   $     204.6    (4.3%)       $     803.3  $     841.4    (4.5%)
                        Medicare                                                     246.8         234.5          5.2%         1,035.3      1,023.9        1.1%
                        Medicaid                                                     191.1         200.4          (4.6%)       751.4        783.2          (4.1%)
                                    Total Managed Care                               633.8         639.5          (0.9%)       2,590.0      2,648.5        (2.2%)
            Life Insurance                                                           40.4          40.0           1.0%         161.8        156.9          3.1%
            Property and Casualty                                                    13.8          23.0           (40.0%)      77.2         87.9           (12.2%)
            Other                                                                    (0.6)         (0.6)          0.0%         (2.1)        (2.7)          22.2%
                                                Consolidated premiums earned, net    $     687.4   $     701.9    (2.1%)       $   2,826.9  $   2,890.6    (2.2%)
Operating revenues (loss): 1
            Managed Care                                                             $     643.6   $     648.6    (0.8%)       $   2,628.2  $   2,686.0    (2.2%)
            Life Insurance                                                           46.7          46.2           1.1%         186.6        181.8          2.6%
            Property and Casualty                                                    17.1          25.3           (32.4%)      86.7         96.8           (10.4%)
            Other                                                                    (0.6)         (0.9)          33.3%        (2.8)        (3.7)          24.3%
                                                Consolidated operating revenues      $     706.8   $     719.2    (1.7%)       $   2,898.7  $   2,960.9    (2.1%)
Operating income (loss): 2
            Managed Care                                                             $       35.9  $      (10.3)  448.5%       $       55.0 $      (36.8)  249.5%
            Life Insurance                                                           6.0           6.6            (9.1%)       19.4         21.5           (9.8%)
            Property and Casualty                                                    (0.8)         2.6            (130.8%)     (6.0)        12.1           (149.6%)
            Other                                                                    -             (0.4)          100.0%       -            (2.0)          100.0%
                                                Consolidated operating income (loss) $       41.1  $        (1.5) (2840.0%)    $       68.4 $        (5.2) (1415.4%)
Operating margin: 3
            Managed Care                                                             5.6%          (1.6%)         720 bp       2.1%         (1.4%)         350 bp
            Life Insurance                                                           12.8%         14.3%          -150 bp      10.4%        11.8%          -140 bp
            Property and Casualty                                                    (4.7%)        10.3%          -1,500 bp    (6.9%)       12.5%          -1,940 bp
            Consolidated                                                             5.8%          (0.2%)         600 bp       2.4%         (0.2%)         260 bp
Depreciation and amortization expense                                                $         3.4 $         3.5  (2.9%)       $       13.2 $       14.1   (6.4%)
1 Operating revenues include premiums earned, net, administrative service fees and net investment income.
2 Operating income or loss include operating revenues minus operating costs. Operating costs include claims incurred and operating expenses.
3 Operating margin is defined as operating income or loss divided by operating revenues.
Managed Care Additional Data                                                                             Three months ended                         Year ended
                                                                                                         December 31,                               December 31,
(Unaudited)                                                                                              2017                 2016                  2017                 2016
Member months enrollment:
                                          Fully-insured                                                  972,095              1,010,374             3,981,347            4,209,920
                                          Self-insured                                                   463,385              526,721               1,967,668            2,144,621
                                                               Total Commercial                          1,435,480            1,537,095             5,949,015            6,354,541
                     Medicare Advantage                                                                  362,277              334,570               1,457,363            1,394,272
                     Medicaid                                                                            1,150,791            1,195,700             4,631,316            4,829,729
                                                                                    Total member months  2,948,548            3,067,365             12,037,694           12,578,542
Claim liabilities (in millions)                                                                                                                     $            367.4   $            349.0
Days claim payable                                                                                                                                  60                   54
Premium PMPM:
                     Managed Care                                                                        $       255.03       $      251.71         $          257.20    $          253.84
                                          Commercial                                                     201.52               202.50                201.77               199.86
                                          Medicare Advantage                                             681.25               700.90                710.39               734.36
                                          Medicaid                                                       166.06               167.60                162.24               162.16
Medical loss ratio:                                                                                      80.9%                88.0%                 85.6%                88.6%
                     Commercial                                                                          72.5%                81.2%                 77.5%                85.2%
                     Medicare Advantage                                                                  82.3%                91.1%                 87.7%                90.3%
                     Medicaid                                                                            87.6%                91.4%                 91.5%                90.1%
Adjusted medical loss ratio: 1                                                                           82.5%                85.1%                 86.1%                87.7%
                     Commercial                                                                          74.5%                80.5%                 77.9%                83.8%
                     Medicare Advantage                                                                  82.9%                85.2%                 88.4%                89.2%
                     Medicaid                                                                            90.4%                89.4%                 91.8%                90.0%
Operating expense ratio:
                     Consolidated                                                                        18.6%                17.9%                 16.8%                17.0%
                     Managed Care                                                                        14.9%                14.9%                 13.6%                14.0%
1 The adjusted medical loss ratio accounts for subsequent adjustments to estimates, such as prior-period reserve developments and Medicare premium adjustments, and presents them in the corresponding period.
Managed Care Membership by Segment          As of December 31,
                                            2017      2016
              Fully-insured                 321,571   335,643
              Self-insured                  153,455   173,514
                     Total Commercial       475,026   509,157
       Medicare Advantage                   118,451   110,297
       Medicaid                             384,462   397,918
                              Total members 977,939   1,017,372
Exhibit V
Reconciliation of Non-GAAP Financial Measures
                                                                                                                                                                                                                                                      Adjusted Net Income
(Unaudited)                                                                                                                                                                                                                                           Three months ended                                                                                 Year ended
                                                                                                                                                                                                                                                      December 31,                                                                                       December 31,
(dollar amounts in millions)                                                                                                                                                                                                                          2017                                                                              2016             2017         2016
Net income                                                                                                                                                                                                                                            $         24.2                                                                    $         12.0   $       54.5 $       17.4
Less adjustments:
                                                                                  Net realized investment gains, net of tax                                                                                                                           2.2                                                                               8.3              8.7          13.9
                                                                                  Private equity investment (loss) income, net of tax                                                                                                                 (0.1)                                                                             0.3              0.3          0.3
                                                                                                                                                                    Adjusted net income                                                               $         22.1                                                                    $           3.4  $       45.5 $         3.2
                                                                                                                                                                    Diluted adjusted net income per share                                             $         0.94                                                                    $         0.14   $       1.89 $       0.13
Adjusted net income is a non-GAAP financial metric and should not be considered a substitute for, or superior to, financial measures calculated in accordance with GAAP. Management believes that the use of this adjusted net income and adjusted net income per share provides investors and management useful information about the earnings impact of realized investment gains and other non-recurring items impacting the Company’s results of operations. This non-GAAP metric does not consider all of the items associated with the Company’s operations as determined in accordance with GAAP. As a result, one should not consider these measures in isolation.

INVESTOR RELATIONS: Mr. Garrett Edson ICR (787) 792-6488

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