Puerto Rico recently has become a hotbed of merger and acquisition activity, with two of the territory’s largest health insurers agreeing to be sold to mainland-based companies. Industry analysts say that the deals are motivated by the same rationale driving most insurer M&A — diversification — though they also caution that the unique regulatory environment in Puerto Rico presents some risks.

GuideWell Mutual Holding Corp., the parent company of Blue Cross Blue Shield of Florida, Inc., said on Aug. 24 that it reached an agreement to purchase Triple-S Management Corp. in a deal worth $900 million. As part of the transaction, GuideWell will acquire all the outstanding shares of Triple-S common stock for $36 per share in cash. Triple-S is Puerto Rico’s largest health insurer, with more than 980,000 members across multiple business lines, according to AIS’s Directory of Health Plans (DHP).

The news of that tie-up comes not long after Anthem, Inc. on June 30 completed its acquisition of Puerto Rico’s largest Medicare Advantage plan, MMM Holdings, LLC, from parent company InnovaCare Health, L.P. The deal boosted Anthem’s MA enrollment by 15%, delivering more than 270,000 Medicare-eligible and dual-eligible members to the publicly traded, Indianapolis-based Blue Cross Blue Shield company.

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