Triple-S Management Corporation (TSM) is the leading managed care company in Puerto Rico. With approximately 2,200,000 customers, TSM reaches 59% of Puerto Rico's population. In addition to its core managed care business, TSM operates two complementary businesses in life, and property and casualty insurance. Since 1965, Triple-S, Inc. has been an independent licensee of the Blue Cross and Blue Shield Association, holding the exclusive rights to the Blue Cross and Blue Shield name and trademark in Puerto Rico and the US Virgin Islands. This provides its members with valuable access to the Blue Card network in the U.S. It is the only managed care company that serves all market sectors, including Medicare, Medicaid, Group and Individual, in Puerto Rico and is one of the most recognized brands locally. For the third consecutive year, Triple-S Salud has been ranked as one of the Top-Ten rated plans for overall Customer Satisfaction by the Federal Employees, among all the plans serving the Federal Government nationwide. Over 90% of all claims are processed electronically.