AM Best has affirmed the Financial Strength Rating (FSR) of A+ (Superior) and the Long-Term Issuer Credit Ratings (Long-Term ICR) of “aa-” (Superior) of Blue Cross and Blue Shield of Florida, Inc. d/b/a Florida Blue, and its affiliates, Health Options, Inc., Capital Health Plan, Inc. (Tallahassee, FL) and Florida Health Care Plan, Inc. (Holly Hill, FL). These companies collectively are referred to as Blue Cross and Blue Shield of Florida Group. AM Best also has affirmed the FSR of A (Excellent) and the Long-Term ICR of “a” (Excellent) of Florida Combined Life Insurance Company, Inc. In addition, AM Best has affirmed the Long-Term ICR of “a-” (Excellent) of GuideWell Mutual Holding Corporation (GuideWell). All of the aforementioned companies are domiciled in Jacksonville, FL, unless otherwise specified. Concurrently, AM Best has affirmed the FSR of A- (Excellent) and the Long-Term ICR of “a-” (Excellent) of Triple-S Vida, Inc. (San Juan, PR) (TSV). The outlook of these Credit Ratings (ratings) is stable.

The ratings reflect Blue Cross and Blue Shield of Florida Group’s balance sheet strength, which AM Best assesses as strongest, as well as its strong operating performance, neutral business profile and appropriate enterprise risk management (ERM).

The rating affirmations of Blue Cross and Blue Shield of Florida Group reflect its material market share in Florida, supported by the strong brand name recognition, a diversified distribution and strong operating performance. The group’s risk-adjusted capitalization is very strong, as measured by Best’s Capital Adequacy Ratio (BCAR). The group continues to benefit from additional financial flexibility from GuideWell and GuideWell Group, Inc. (GGI). The organization maintains dedicated assets at GGI to support risk-adjusted capitalization as necessary. The group’s risk-adjusted capitalization remains more than sufficient to support the organization’s underwriting and investment risks. The group has maintained favorable overall liquidity and has access to additional sources of operating liquidity, including access to a revolving credit facility at GuideWell and available credit facilities at the Federal Home Loan Bank of Atlanta for Florida Blue and Health Options, Inc.

Blue Cross and Blue Shield of Florida Group has strategic relationships with a diverse group of provider networks and a balanced product portfolio that drove favorable premium development in 2023. The group has generated positive operating earnings over the past five years, despite operating in a highly competitive market. Growth in Blue Cross and Blue Shield of Florida Group's profitability was driven by risk-adjusted premiums, the performance of its investment portfolio and underwriting results in the commercial segment.

The ratings of Florida Combined Life Insurance Company, Inc. reflect its balance sheet strength, which AM Best assesses as very strong, as well as its adequate operating performance, limited business profile and appropriate ERM.

The rating affirmations consider Florida Combined Life Insurance Company, Inc.’s maintaining its strongest level of risk-adjusted capitalization, as measured by BCAR. Despite dividend payments to its parent, the company has reported year-over-year capital growth until 2023 and continues to generate favorable operating results. The company also provides product diversification through selling Blue Cross Blue Shield-branded dental, life, and disability insurance products, providing the organization with supplemental products.

The ratings of TSV reflect its balance sheet strength, which AM Best assesses as adequate, as well as its adequate operating performance, limited business profile and appropriate ERM.

The rating affirmations reflect TSV’s risk-adjusted capitalization being assessed at the adequate level, as measured by BCAR. Capital growth during 2023 was the result of a sizable unrealized gain. However, the GuideWell organization maintains dedicated assets to support risk-adjusted capitalization if necessary. TSV’s premiums have consistently grown, and the company has remained profitable over the past five years; however, earnings have been decreasing since 2020. During 2023, underwriting losses were offset by net investment income, but realized capital loss reduced net income.

TSV markets under the Blue Cross and Blue Shield brand in Puerto Rico, the US Virgin Islands, Costa Rica, the British Virgin Islands and Anguilla. The Triple-S name carries strong brand recognition in the areas that it serves. The company is a leading life and health insurance company providing a diversified portfolio of insurance products in Puerto Rico. However, operating in a single market, which has been depressed for a prolonged period of time, exposes TSV to geographic concentration. AM Best acknowledges the group’s ERM is integrated with the parent organization, which is a comprehensive and mature program.

This press release relates to Credit Ratings that have been published on AM Best’s website. For all rating information relating to the release and pertinent disclosures, including details of the office responsible for issuing each of the individual ratings referenced in this release, please see AM Best’s Recent Rating Activity web page. For additional information regarding the use and limitations of Credit Rating opinions, please view Guide to Best's Credit Ratings. For information on the proper use of Best’s Credit Ratings, Best’s Performance Assessments, Best’s Preliminary Credit Assessments and AM Best press releases, please view Guide to Proper Use of Best’s Ratings & Assessments.

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