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                      EXCHANGE ACT OF 1934 (AMENDMENT NO. )

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                         TRIPLE-S MANAGEMENT CORPORATION
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April 16, 2004



My fellow Shareholder:

It is important that you express your opinion regarding the matters to be
considered at the Annual Meeting of Shareholders to be held on April 25. We
present the answers to the questions ask for some of our fellow shareholders.

WHAT MATTERS ARE YOU GOING TO CONSIDER AND VOTE ON NEXT APRIL 25?

         You are going to act upon the election of 8 directors and 4
resolutions.

WHAT MATTERS ARE CONSIDERED IN THE RESOLUTIONS?

         The Board of Directors recommends that you vote in favor of Resolutions
         1, 2 and 3, since they are very important for you and the development
         of Triple-S Management.

         -        NUMBER 1 was discussed in detail in our letter previously sent
                  to you. Nevertheless, we want to recall it again. This
                  Resolution is presented by the Board of Directors to allow a
                  Shareholder to transfer his or her shares to another physician
                  or dentist, provided no payment is involved and that the 21
                  share limit requirement is complied with. The Board of
                  Directors is asking for a vote IN FAVOR of the Resolution
                  Number 1.

         -        NUMBER 2 proposes some amendments to promote that the Board of
                  Directors performs its duties in accordance with the new
                  corporate governance practices pursuant to the Sarbanes-Oxley
                  Act requirements. These changes ensure that decisions are
                  taken following the best corporate business practices. This
                  Resolution is presented by the Board of Directors. The Board
                  of Directors is asking for a vote IN FAVOR of the Resolution
                  Number 2.

         -        NUMBER 3 was also discussed in detail in our previous letter.
                  This Resolution will allow the approval of some amendments to
                  the Articles of Incorporation and By-laws if the affirmative
                  vote requirement of 3/4 voting shares is reduced to 2/3.
                  Recently, some proposals, that were necessary and supported by
                  the majority of the Shareholders, could not be approved since
                  they did not meet the extraordinary affirmative vote
                  requirement. This Resolution is presented by our fellow
                  shareholder, Dr. Leslie H. Lopez Velez. The Board of Directors
                  is asking for a vote IN FAVOR of the Resolution Number 3.

         -        NUMBER 4 presented by Guillermo J. Fernandez Marti, MD,
                  requests that Triple-C takes the necessary steps to obtain the
                  National Committee of Quality Assurance's (NCQA) accreditation
                  within a time frame of no more than six (6) months. The Board
                  of Directors is asking for a vote against this resolution. The
                  reasons to request a vote against are explained in detail in
                  the Proxy Statement. The Board of Directors is asking for a
                  vote AGAINST the Resolution Number 4.





HOW CAN YOU EXPRESS YOUR OPINION REGARDING THE MATTERS TO BE CONSIDERED ON

         APRIL 25? You should send your proxy to the Board or may vote in
         person.

WHERE CAN YOU CALL IF YOU NEED TO GET MORE INFORMATION?

         If you would like more information please contact Rosa Gonzalez, who
         heads the Office of Shareholders Services and Relations, at telephone
         (787) 277-6621 or at 1-800-350-8552.


TRIPLE-S COUNTS ON YOU.


/s/ Dr. Fernando J. Ysern-Borras
------------------------------------
Dr. Fernando J. Ysern-Borras
Chairman of the Board of Directors


                             YOUR VOTE IS IMPORTANT.
  WE STRONGLY ENCOURAGE YOU TO SEND IN THE PROXY THE BOARD HAS REQUESTED AT THE
               FOLLOWING FAXES: (787) 749-4191 OR (787) 706-4023