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8-K - TRIPLE-S MANAGEMENT CORPORATION 8-K 10-31-2012 - TRIPLE-S MANAGEMENT CORPform8k.htm

EXHIBIT 99.1


Triple-S Management Corporation
`                                                                           1441 F.D. Roosevelt Ave.
San Juan, PR 00920
www.triplesmanagement.com
 
FOR FURTHER INFORMATION:

AT THE COMPANY:
INVESTOR RELATIONS:
Alan Cohen
Kathy Waller
Chief Marketing & Communications Officer
AllWays Communicate, LLC
(787) 706-2570
(312) 543-6708

Triple-S Management Corporation Reports Third Quarter 2012 Results

SAN JUAN, Puerto Rico, October 31, 2012 – Triple-S Management Corporation (NYSE:GTS), the leading managed care company in Puerto Rico, today announced consolidated revenues of $606.2 million and operating income of $15.5 million for the three months ended September 30, 2012.  Net income was $11.7 million, or $0.41 per diluted share.

September-Quarter Consolidated Highlights

 
·
Total consolidated operating revenues were $605.6 million;
 
·
Operating income was $15.5 million;
 
·
Consolidated loss ratio was 85.8%;
 
·
Medical loss ratio (MLR) was 89.7%;
 
·
Managed Care member month enrollment increased 111.0%;
 
·
Medicare member month enrollment rose 15.6%.

Ramón M. Ruiz-Comas, President and Chief Executive Officer of Triple-S Management Corporation, said, “We recorded another quarter of solid top-line growth, driven by premium increases across all our managed care segments. In our Medicare business, we maintained a healthy mid-teens gain in membership.  We did, however, experience a higher-than-normal increase in claims in the Commercial business, the result of more hospital admissions and increased surgical procedures, which had been tracking at lower levels in the first half of the year.  Nonetheless, the period’s results were in line with internal expectations since the third quarter typically has the second highest utilization rate in any given year.  As we enter the fourth quarter, our seasonally strongest, we are reaffirming our 2012 outlook.

“In mid-October, CMS released Medicare Advantage Star ratings for 2013 and all of our plans demonstrated improvement.  Our sales force now has a full array of MA products to offer as we proceed through open enrollment season,” continued Ruiz-Comas.

“Recently, we entered into an agreement with Abarca Health, a Puerto-Rico based provider of healthcare information technology, clinical solutions, and pharmacy benefit management services, under which it will serve as American Health’s new PBM.  This agreement, effective January 1, 2013, will provide us with more favorable pricing, allowing us to better control our pharmacy costs in 2013 and beyond.”
 
 
 

 
 
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Ruiz-Comas added, “To drive better performance in the Medicare Advantage segment, Susan Rawlings-Molina has been designated to head up the entire MA division.  Susan, President and CEO of Socios Mayores en Salud, Inc. (the holding company of American Health), is an accomplished executive who has worked at several major U.S. managed care organizations during her career.  Her first task will be to restructure the MA business, streamline our operations and increase accountability, creating greater efficiency and positioning us for further improvement in our Star ratings.

“In addition, we recently appointed Juan José Díaz-Goitía to the position of Chief Information Officer.  Formerly Executive Vice President of Triple-S Vida, Juan José had previously been Chief Information Officer for Latin America and Puerto Rico at Verizon Information Services.  In his new role, he will integrate the technology function across our family of companies to improve efficiency and service to all of our constituents,” Ruiz-Comas concluded.
 
Selected Quarterly Details

 
·
Pro Forma Net Income was $11.7 million, or $0.41 Per Diluted Share.  Weighted average shares outstanding were 28.5 million.  This compares with pro forma net income of $12.3 million, or $0.43 per diluted share, in the corresponding quarter of 2011, based on weighted average shares outstanding of 28.9 million.
 
·
Consolidated Premiums Increased 7.7%, to $565.6 Million.  The increase was principally due to higher member month enrollment in the Medicare and Commercial businesses, as well as higher average Commercial per-member, per-month premiums.
 
·
Consolidated Administrative Service Fees Rose 423.1%, to $27.2 Million.  The significant increase in service fees was driven by the addition of the Medicaid ASO business (miSalud), effective November 1, 2011.
 
·
Managed Care Membership.  Our Managed Care membership grew by 109.8% year over year, reflecting the addition of the miSalud business, in which self-insured membership was 872,496 at the end of the quarter.  Medicare membership increased 14.8% year-over-year, to 122,925.  Fully-insured Commercial membership was up 0.5% from the same period last year.
 
·
Managed Care MLR Increased 200 Basis Points, to 89.7%.  The increased MLR results from higher member month enrollment in Medicare Advantage, which has a higher MLR than the Commercial business, and to greater-than-expected utilization and cost trends in the Medicare segment.  The Commercial business also experienced higher utilization and cost trends, primarily due to hospital admissions and surgical procedures.
 
·
Consolidated Loss Ratio Increased 160 Basis Points, to 85.8%.  The higher consolidated loss ratio mainly reflects the 200-basis-point increase in the Managed Care MLR and an increase in the claims incurred in the Life segment, resulting from a higher loss ratio in the Cancer business and an increase in the liability for future policy benefits.
 
·
Consolidated Operating Expense Ratio Rose 180 Basis Points, to 17.6%.  The higher consolidated operating expense ratio is due to the increase in self-insured contracts associated with our participation in the miSalud program.
 
·
Consolidated Operating Income Decreased 6.6%, to $15.5 Million.  The decrease reflects the increased MLR in the Medicare business, partly offset by the contribution from the miSalud program, and the improved operating income of the Property and Casualty segment.
 
 
 

 
 
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·
Consolidated Operating Income Margin Was 2.6%. The 50-basis-point decrease in the consolidated operating margin is primarily the result of the lower profitability in our Managed Care and Life Insurance businesses, offset, in part, by the improved profit margin of the Property and Casualty Insurance segment.
 
·
Consolidated Effective Tax Rate Was 11.4%.  The lower effective tax rate reflects the decrease in taxable income in the Managed Care Insurance segment.  The consolidated income tax expense decreased by $0.4 million, or 21.1%, during this quarter.
 
·
Parent Company Information.  During this quarter, Triple-S Management repaid $25.0 million in long-term debt with a 6.7% interest rate, at no premium.
 
   
Pro Forma Net Income
             
(Unaudited)
 
Three months
ended
September 30,
   
Nine months
ended
September 30,
 
(dollar amounts in millions)
 
2012
   
2011
   
2012
   
2011
 
Net income
  $ 11.7     $ 11.6     $ 36.3     $ 39.1  
Less pro forma adjustments:
                               
Net realized investment gains, net of tax
    -       4.7       1.8       15.7  
Net unrealized trading investments,net of tax
    -       (5.1 )     -       (6.2 )
Derivative loss, net of tax
    -       (0.3 )     -       (0.6 )
Charge related to change in enacted tax rate
    -       -       -       (6.4 )
Pro forma net income
  $ 11.7     $ 12.3     $ 34.5     $ 36.6  
Diluted pro forma net income per share
  $ 0.41     $ 0.43     $ 1.21     $ 1.26  

Nine-Month Recap

For the nine months ended September 30, 2012, consolidated operating revenues increased 15.2%, to $1.8 billion, primarily reflecting higher member month enrollment in the Medicare and Commercial segments, the addition of the miSalud business, and the receipt of higher Medicare risk score adjustments in 2012 when compared with the prior year.  Consolidated claims incurred for the nine-month period were $1.5 billion, up 14.5% year over year.  The nine-month consolidated loss ratio increased 230 basis points to 86.0%, while the MLR rose 190 basis points, to 89.6%.  This increase was driven by higher MA member month enrollment, which has an inherently higher MLR than the Commercial business, and higher-than-expected utilization and cost trends in the Medicare business, primarily at American Health.  Consolidated operating expenses for the nine months ended September 30, 2012 were $309.4 million and the operating expense ratio was 17.4%.  Pro forma net income for the nine-month period was $34.5 million, or $1.21 per diluted share, based on weighted average shares outstanding of 28.5 million, compared with $36.6 million, or $1.26 per diluted share, based on weighted average shares outstanding of 29.0 million at the same time last year.
 
 
 

 
 
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Segment Performance

Triple-S Management operates in three segments: 1) Managed Care, 2) Life Insurance, and 3) Property and Casualty Insurance.  Management 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 minus operating expenses.  Operating margin is defined as operating income or loss divided by operating revenues.

(Unaudited)
 
Three months ended September 30,
   
Nine months ended September 30,
 
(dollar amounts in millions)
 
2012
   
2011
   
Percentage Change
   
2012
   
2011
   
Percentage Change
 
Premiums earned, net:
                                   
Managed Care:
                                   
Commercial
  $ 240.5     $ 234.4       2.6 %   $ 724.9     $ 703.2       3.1 %
Medicare
    268.0       238.0       12.6 %     807.9       658.5       22.7 %
Medicaid
    -       -               -       2.7       (100.0 %)
Total Managed Care
    508.5       472.4       7.6 %     1,532.8       1,364.4       12.3 %
Life Insurance
    31.8       28.8       10.4 %     92.5       83.7       10.5 %
Property and Casualty
    25.9       24.9       4.0 %     71.7       74.5       (3.8 %)
Other
    (0.6 )     (0.7 )     (14.3 %)     (1.8 )     (2.1 )     (14.3 %)
Consolidated premiums earned, net
  $ 565.6     $ 525.4       7.7 %   $ 1,695.2     $ 1,520.5       11.5 %
Operating revenues:
                                               
Managed Care
  $ 540.8     $ 483.3       11.9 %   $ 1,630.5     $ 1,399.9       16.5 %
Life Insurance
    37.0       33.4       10.8 %     107.8       97.2       10.9 %
Property and Casualty
    28.1       27.4       2.6 %     78.4       81.6       (3.9 %)
Other
    (0.3 )     (1.5 )     (80.0 %)     (1.4 )     (2.9 )     (51.7 %)
Consolidated operating revenues
  $ 605.6     $ 542.6       11.6 %   $ 1,815.3     $ 1,575.8       15.2 %
Operating income:
                                               
Managed Care
  $ 7.3     $ 11.2       (34.8 %)   $ 33.3     $ 32.6       2.1 %
Life Insurance
    4.1       5.3       (22.6 %)     12.5       13.2       (5.3 %)
Property and Casualty
    1.9       (1.1 )     272.7 %     4.1       2.0       105.0 %
Other
    2.2       1.2       83.3 %     (1.4 )     2.9       (148.3 %)
Consolidated operating income
  $ 15.5     $ 16.6       (6.6 %)   $ 48.5     $ 50.7       (4.3 %)
Operating margin:
                                               
Managed Care
    1.3 %     2.3 %     -100 bp     2.0 %     2.3 %     -30 bp
Life Insurance
    11.1 %     15.9 %     -480 bp     11.6 %     13.6 %     -200 bp
Property and Casualty
    6.8 %     (4.0 %)     1,080 bp     5.2 %     2.5 %     270 bp
Consolidated
    2.6 %     3.1 %     -50 bp     2.7 %     3.2 %     -50 bp
Depreciation and amortization expense
  $ 6.2     $ 5.9       5.1 %   $ 18.0     $ 16.4       9.8 %

 
 

 
 
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Managed Care Additional Data
 
Three months ended
September 30,
   
Nine months ended
September 30,
 
(Unaudited)
 
2012
   
2011
   
2012
   
2011
 
Member months enrollment:
                       
Commercial:
                       
Fully-insured
    1,448,985       1,440,393       4,375,260       4,362,829  
Self-insured
    676,007       670,150       2,007,635       2,058,365  
Total Commercial
    2,124,992       2,110,543       6,382,895       6,421,194  
Medicare:
                               
Medicare Advantage
    342,180       291,628       1,011,150       823,264  
Stand-alone PDP
    25,502       26,444       76,197       79,648  
Total Medicare
    367,682       318,072       1,087,347       902,912  
Medicaid - Self-insured
    2,631,532       -       7,886,395       -  
Total member months
    5,124,206       2,428,615       15,356,637       7,324,106  
Claim liabilities (in millions)
  $ 297.2     $ 262.2 *                
Days claim payable
    60.0       59.4 *                
Premium PMPM:
                               
Managed Care
  $ 279.91     $ 268.64     $ 280.60     $ 259.11  
Commercial
    165.98       162.73       165.68       161.18  
Medicare
    728.89       748.26       743.00       729.31  
Medical loss ratio
    89.7 %     87.7 %     89.6 %     87.7 %
Commercial
    89.8 %     87.3 %     89.2 %     87.6 %
Medicare Advantage
    89.5 %     88.6 %     89.7 %     88.7 %
Stand-alone PDP
    75.9 %     73.2 %     83.8 %     76.5 %
Adjusted medical loss ratio
    90.4 %     86.1 %     89.6 %     86.6 %
Commercial
    88.6 %     86.2 %     88.5 %     86.4 %
Medicare Advantage
    92.1 %     86.0 %     90.5 %     86.8 %
Stand-alone PDP
    75.1 %     73.5 %     82.7 %     76.8 %
Operating expense ratio:
                               
Consolidated
    17.6 %     15.8 %     17.4 %     16.4 %
Managed Care
    14.4 %     12.1 %     13.8 %     12.3 %

*
Information provided as of December 31, 2011.
 
 
 

 
 
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Managed Care Membership by Segment
 
As of September 30,
 
   
2012
   
2011
 
Members:
           
Commercial:
           
Fully-insured
    483,103       476,329  
Self-insured
    225,540       228,663  
Total Commercial
    708,643       704,992  
Medicare:
               
Medicare Advantage
    114,419       98,231  
Stand-alone PDP
    8,506       8,822  
Total Medicare
    122,925       107,053  
Medicaid - Self-insured
    872,496       -  
Total members
    1,704,064       812,045  
 
2012 Guidance

The company’s full-year outlook, which remains unchanged, is detailed below.

   
2012 Range
 
       
Medical enrollment fully-insured (member months)
 
7.2-7.4 million
 
       
Medical enrollment self-insured (member months)
 
12.7-13.0 million
 
       
Consolidated operating revenues  (in billions)
  $ 2.3-$2.4  
         
Consolidated loss ratio
    85.0%-86.0 %
         
Medical loss ratio
    88.8%-89.8 %
         
Consolidated operating expense ratio
    17.2%-18.2 %
         
Consolidated operating income (in millions)
  $ 67.0-$77.0  
         
Consolidated effective tax rate
    23%-24 %
         
Pro forma earnings per share
  $ 1.80-$1.85  
         
Weighted average of diluted shares outstanding (in millions)
    28.5  

 
 

 
 
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Conference Call and Webcast

Management will host a conference call and webcast on October 31, 2012 at 9:30 a.m., Eastern Time to discuss its financial results for the three months ended September 30, 2012.  To participate, callers within the U.S. and Canada should dial 1-877-941-0844, and international callers should dial 1-480-629-9835 about five minutes before the presentation.

To listen to the webcast, participants should visit the “Investor Relations” section of the Company’s Web site at www.triplesmanagement.com 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 Web site, 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 Web site.

About Triple-S Management Corporation

Triple-S Management Corporation is an independent licensee of the Blue Cross Blue Shield Association.  It is the leading player in the managed care industry in Puerto Rico.  Triple-S Management also has the exclusive right to use the Blue Cross Blue Shield name and mark throughout Puerto Rico and the U.S. Virgin Islands.  With more than 50 years of experience in the industry, Triple-S Management offers a broad portfolio of managed care and related products in the Commercial and Medicare Advantage markets under the Blue Cross Blue Shield brand through its subsidiary Triple-S Salud, Inc. and effective February 2011, also offers non-branded Medicare products through American Health Inc.  In addition to its managed care business, Triple-S Management provides non-Blue Cross Blue Shield branded life and property and casualty insurance in Puerto Rico.

For more information about Triple-S Management, visit www.triplesmanagement.com or contact kwaller@allwayscommunicate.com.

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:
 
 
 

 
 
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·
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
·
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 Employer, 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.

-FINANCIAL TABLES ATTACHED-
 
 
 

 
 
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Condensed Consolidated Balance Sheets
(Dollar amounts in thousands, except per share data)

 
Unaudited
September 30,
2012
 
December 31,
2011
 
Assets
           
             
Investments
  $ 1,308,700     $ 1,153,293  
Cash and cash equivalents
    68,750       71,834  
Premium and other receivables, net
    283,349       287,184  
Deferred policy acquisition costs and value of business acquired
    164,128       155,788  
Property and equipment, net
    96,818       81,872  
Other assets
    129,393       130,606  
                 
Total assets
  $ 2,051,138     $ 1,880,577  
                 
Liabilities and Stockholders’ Equity
               
                 
Policy liabilities and accruals
  $ 916,437     $ 836,029  
Accounts payable and accrued liabilities
    268,905       253,202  
Short-term borrowings
    11,200       -  
Long-term borrowings
    101,762       114,387  
                 
Total liabilities
    1,298,304       1,203,618  
                 
Stockholders’ equity:
               
Common stock
    28,461       28,365  
Other stockholders equity
    724,066       648,594  
                 
Total Triple-S Management Corporation stockholders' equity
    752,527       676,959  
                 
Noncontrolling interest in consolidated subsididary
    307       -  
                 
Total stockholders' equity
    752,834       676,959  
                 
Total liabilities and stockholders’ equity
  $ 2,051,138     $ 1,880,577  
 
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Condensed Consolidated Statements of Earnings
(Dollar amounts in thousands, except per share data)

  For the Three Months Ended   For the Nine Months Ended  
 
September 30,
 
September 30,
 
 
Unaudited
2012
 
Unaudited
2011
 
Unaudited
2012
 
Unaudited
2011
 
Revenues:
                       
Premiums earned, net
  $ 565,607     $ 525,371     $ 1,695,157     $ 1,520,485  
Administrative service fees
    27,181       5,210       82,473       18,767  
Net investment income
    11,595       12,061       34,349       36,513  
Other operating revenues
    1,206       -       3,358       -  
                                 
Total operating revenues
    605,589       542,642       1,815,337       1,575,765  
                                 
Net realized investment gains
    21       5,569       2,157       18,457  
Net unrealized investment loss on trading securities
    -       (6,007 )     -       (7,267 )
Other income (expenses), net
    598       (169 )     1,514       311  
                                 
Total revenues
    606,208       542,035       1,819,008       1,587,266  
                                 
Benefits and expenses:
                               
Claims incurred
    485,495       442,399       1,457,388       1,272,913  
Operating expenses
    104,604       83,623       309,378       252,216  
                                 
Total operating costs
    590,099       526,022       1,766,766       1,525,129  
                                 
Interest expense
    2,956       2,499       8,181       8,583  
                                 
Total benefits and expenses
    593,055       528,521       1,774,947       1,533,712  
                                 
Income before taxes
    13,153       13,514       44,061       53,554  
                                 
Income tax expense
    1,470       1,901       7,862       14,485  
                                 
Net income
    11,683       11,613       36,199       39,069  
                                 
Less: Net loss attributable to the noncontrolling interest
    32       -       65       -  
                                 
Net income attributable to TSM
  $ 11,715     $ 11,613     $ 36,264     $ 39,069  
                                 
Earnings per share attributable to TSM:
                               
                                 
Basic net income per share
  $ 0.41     $ 0.40     $ 1.28     $ 1.36  
Diluted earnings per share
  $ 0.41     $ 0.40     $ 1.27     $ 1.35  
 
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Triple-S Management Corporation
Add 11
Condensed Consolidated Statements of Cash Flows
(Dollar amounts in thousands, except per share data)

 
For the Nine Months Ended
 
 
September 30,
 
 
Unaudited
2012
 
Unaudited
2011
 
             
Net cash provided by operating activities
  $ 112,094     $ 216,909  
                 
Cash flows from investing activities:
               
Proceeds from investments sold or matured:
               
Securities available for sale:
               
Fixed maturities sold
    67,943       225,060  
Fixed maturities matured/called
    115,649       76,786  
Equity securities
    50,016       31,253  
Securities held to maturity:
               
Fixed maturities matured/called
    11,080       1,941  
Acquisition of investments:
               
Securities available for sale:
               
Fixed maturities
    (278,533 )     (212,358 )
Equity securities
    (78,135 )     (111,770 )
Securities held to maturity:
               
Fixed maturities
    (1,067 )     (755 )
Other investments
    18       -  
Net inflows (outflows) from policy loans
    84       (392 )
Acquisition of business, net of cash acquired of $816 and $29,370 in the nine months ended September 30, 2012 and 2011, respectively
    (2,685 )     (54,058 )
Net capital expenditures
    (8,756 )     (12,000 )
                 
Net cash used in investing activities
    (124,386 )     (56,293 )
                 
Cash flows from financing activities:
               
Change in outstanding checks in excess of bank balances
    (3,332 )     (9,275 )
Net change in short-term borrowings
    11,200       (15,575 )
Repayments of long-term borrowings
    (26,464 )     (51,230 )
Repurchase and retirement of common stock
    (637 )     (7,554 )
Cash settlements of stock options
    -       (2,420 )
Proceeds from exercise of stock options
    316       189  
Proceeds from policyholder deposits
    32,946       20,725  
Surrenders of policyholder deposits
    (4,821 )     (4,580 )
                 
Net cash provided by (used in) financing activities
    9,208       (69,720 )
                 
Net (decrease) increase in cash and cash equivalents
    (3,084 )     90,896  
                 
Cash and cash equivalents, beginning of period
    71,834       45,021  
                 
Cash and cash equivalents, end of period
  $ 68,750     $ 135,917  
 
 
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