MMIT Payer Portrait: Triple-S Management Corp.

Founded by a group of providers in 1959, Triple-S Management Corp. is now a publicly traded company and the largest insurer in Puerto Rico, serving 35% of the U.S. territory’s insured population. It is also the primary Blue Cross and Blue Shield affiliate for the island. Miami-based Abarca Health serves as Triple-S’s pharmacy benefits manager for commercial and Medicare products, while ProCare Rx subsidiary MC-Rx serves the Medicaid population.

While Triple-S offers coverage across the spectrum of health insurance products, the insurer has a large Medicaid presence, serving about 36% of Puerto Rico’s sizeable Medicaid population. Like other large insurers, Triple-S’s Medicaid enrollment boomed in the wake of the COVID-19 pandemic, spiking 80% from pre-pandemic numbers of about 355,000 lives to 442,000 lives as of the latest update to AIS’s Directory of Health Plans.

The insurer also saw sizeable reductions in its group risk and self-funded administrative services only (ASO) offerings from pre-pandemic 2020 to 2021.

In August 2021, GuideWell Mutual Holding Company, the parent of Florida Blue, entered an agreement to acquire Triple-S in a $900 million deal. With 3.7 million members, Florida Blue is the largest insurer in Florida and stands to enter the top 10 by overall enrollment nationally when the deal closes. In an Aug. 24 press release, both companies said the increased ability to compete and invest in their offerings will fuel improved health outcomes and create more access to care. The move will also help Florida Blue better serve its Spanish-speaking and Puerto Rican members as the company seeks to improve outcomes through localized, person-focused care, according to executives. “With Puerto Rico’s outlook strengthening, and Florida experiencing fast-paced growth, especially in its Puerto Rican and Hispanic populations, this is a natural next step,” Pat Geraghty, president and CEO of GuideWell and Florida Blue, said in the press release. The deal is expected to close in the first half of 2022.

*Anthem, Inc. completed its acquisition of InnovaCare in June 2021.

SOURCE: AIS’s Directory of Health Plans as of September 2021; MMIT Analytics as of 3Q 2021.

© 2024 MMIT
Carina Belles

Carina Belles

Carina is a reporter at AIS, specializing in public sector data research, trend analysis and infographics. She holds a Bachelor of Science in Journalism from Ohio University, joining AIS shortly after graduating in 2014.

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