Triple-S Management Corp. CEO Ramón Ruiz-Comas will retire next January, ending a 13-year tenure as the top executive of Puerto Rico's Blue Cross and Blue Shield health plan. Triple-S COO Roberto García-Rodríguez will take over for Ruiz-Comas.
Triple-S covers more than 2.1 million Puerto Ricans, meaning 3 out of 5 residents have a Blue Cross health plan. Ruiz-Comas, 58, joined Triple-S in 1990 and took the company public in 2007, making it one of the largest conglomerates on the island. The company recorded $65.7 million of profit on $2.32 billion of revenue in 2014.
Ruiz-Comas made $4.2 million in 2014 and more than $10 million since 2012, thanks in large part to company stock awards. García-Rodríguez took home $1.2 million in 2014.
Triple-S is operating in a territory that is often excluded from the broader healthcare reform debate. But Puerto Rico has embraced several portions of the Affordable Care Act, getting $925 million between 2014 and 2019 from the federal government, much of it tied to Medicaid.
Medicaid rolls have swelled since 2012 when Puerto Rico expanded Mi Salud. The health insurance program for the poor consequently has become a larger part of Triple-S. Two-thirds of the company's members are on Medicaid, compared with half in 2012.
Puerto Rico is also a very poor territory, as shown by the high rates of Medicaid. Its per-capita income is less than $20,000, and more than 45% of Puerto Ricans live in poverty. The poverty rate is almost twice that of Mississippi, the poorest U.S. state.
Fully insured employer business has been declining at Triple-S, a trend seen elsewhere around the country with more companies deciding to self-insure and rely on insurance companies only for administrative processes. Several Triple-S commercial accounts have lost members or have been canceled altogether “as a result of Puerto Rico's challenging economic situation,” the company said last year.
Triple-S and other Puerto Rican healthcare organizations have also asked the CMS to revise its Medicare Advantage rates. Dennis Rivera, chairman of the Puerto Rico Healthcare Crisis Coalition, said Monday that “Puerto Rico's Medicare Advantage program will no longer be viable next year if funding to insurers isn't restored by June 1.” Several Democratic members of Congress, as well as Republican presidential hopeful Sen. Marco Rubio of Florida, wrote to HHS last month asking for the rates to be revised upward.