TRIPLE-S MANAGEMENT CORP
EX-10.3(C) EXTENSION TO HEALTH INSURANCE CONTRACT
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<TYPE>EX-10.3(C)
<SEQUENCE>6
<FILENAME>g06023exv10w3xcy.htm
<DESCRIPTION>EX-10.3(C) EXTENSION TO HEALTH INSURANCE CONTRACT
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<DIV align="right" style="font-size: 10pt; margin-top: 12pt"><B>Exhibit&nbsp;10.3(c)</B>
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<DIV align="center" style="font-size: 10pt; margin-top: 18pt"><B>2003-000021-i</B>
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<DIV align="Center" style="font-size: 10pt; margin-top: 6pt"><B>HEALTH INSURANCE CONTRACT<BR>
NO. 03-021 FOR THE</B><br>

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<DIV align="Center" style="font-size: 10pt; margin-top: 6pt"><B>SOUTH WEST HEALTH REGION<BR>
BETWEEN<BR>
PUERTO RICO HEALTH INSURANCE ADMINISTRATION<BR>
AND<BR>
TRIPLE S, INC.</B>

</DIV>
<DIV align="left" style="font-size: 10pt; margin-top: 6pt">This Amendment entered into this <B>31<SUP style="font-size: 85%; vertical-align: text-top"><B>th</B></SUP>&nbsp;day of October, 2006</B>, at San Juan, Puerto Rico, by and between
<B>PUERTO RICO HEALTH INSURANCE ADMINISTRATION</B>, a public instrumentality of the Commonwealth of Puerto
Rico, organized under Law 72 approved on September&nbsp;7, 1993, hereinafter referred to as the
"<B>ADMINISTRATION</B>&#148;, represented by its Executive Director, <B>Minerva Rivera, Esq.</B>, and <B>TRIPLE S, INC. </B>a
domestic corporation duly organized and doing business under the laws of the Commonwealth of Puerto
Rico, with employer social security number ###-##-####, hereinafter referred to as the &#147;<B>INSURER</B>&#148;
represented by its Chief Executive Director, <B>Socorro Rivas</B>.
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<DIV align="Center" style="font-size: 10pt; margin-top: 6pt"><B>WITNESSETH</B>

</DIV>
<DIV align="left" style="font-size: 10pt; margin-top: 6pt">In consideration of the mutual covenants and agreements hereinafter set forth, the parties, their
personal representatives and successors, agree as follows:
</DIV>

<DIV align="left" style="font-size: 10pt; margin-top: 6pt"><B>WHEREAS: </B>On June&nbsp;13th, 2002, the <B>ADMINISTRATION </B>and <B>INSURER </B>entered into Contract No.&nbsp;03-021 for
the South West Health Region, a three-year contract with an effective date of July 1<SUP style="font-size: 85%; vertical-align: text-top">st</SUP>,
2002 (the &#147;Contract&#148;) subject to annual renegotiations of the premiums. Said contract provides
health insurance coverage to all enrollees in and within the <B>South West Health Area/Region</B>,
composed of the municipalities of <B>Adjuntas, Gu&#225;nica, Guayanilla, Jayuya, Pe&#241;uelas, Ponce and Yauco.</B>
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<DIV align="left" style="font-size: 10pt; margin-top: 6pt"><B>WHEREAS: </B>On July&nbsp;2006 the <B>ADMINISTRATION </B>agreed with the Insurer to amend<BR>
the contract to establish interim premiums rates for the period of time from July 1<SUP style="font-size: 85%; vertical-align: text-top">st</SUP>,
2006 until September&nbsp;30 2006. Due to the Agency considerations that period was extended to October
31<SUP style="font-size: 85%; vertical-align: text-top">st</SUP>, 2006.
</DIV>

<DIV align="left" style="font-size: 10pt; margin-top: 6pt"><B>HENCEFORTH: </B>The Contract is hereby amended to read as follows:
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<DIV align="center" style="font-size: 10pt; margin-top: 18pt"><B>ARTICLE XVIII<BR>
PAYMENT OF PREMIUMS</B>
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<DIV align="left" style="font-size: 10pt; margin-top: 6pt"><B>In Article&nbsp;XVIII paragraph three (3)&nbsp;letters (a)&nbsp;to (e)&nbsp;are deleted, substituted with the following
to read as follows:</B>
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<TABLE width="100%" border="0" cellpadding="0" cellspacing="0" style="font-size: 10pt">

<TR valign="top" style="font-size: 10pt; color: #000000; background: transparent">
    <TD width="1%" nowrap align="left"><B>3.</B></TD>
    <TD width="1%">&nbsp;</TD>
    <TD><B>a. </B>The final monthly premiums rates for all beneficiaries, including all those who are
sixty-five (65)&nbsp;years and older who are Medicare beneficiaries Part&nbsp;A or Part&nbsp;A and B those
who are sixty-five years and older who are not Medicare recipients is establish in <B>sixty
six dollars and sixty cents ($66.60</B>) per member per
month (<B><I>pmpm</I></B>).</TD>
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<DIV style="margin-top: 6pt">
<TABLE width="100%" border="0" cellpadding="0" cellspacing="0" style="font-size: 10pt">

<TR valign="top" style="font-size: 10pt; color: #000000; background: transparent">
    <TD width="2%" style="background: transparent">&nbsp;</TD>
    <TD width="3%" nowrap align="left"><B>b.</B></TD>
    <TD width="1%">&nbsp;</TD>
    <TD>The aforementioned premium rate constitutes the <B>final </B>rates for the period
beginning July 1<SUP style="font-size: 85%; vertical-align: text-top">st</SUP>, 2006 to October&nbsp;31, 2006. Payments will be made from
account number 5030-113.</TD>
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<TR>
    <TD style="font-size: 6pt">&nbsp;</TD>
</TR><TR valign="top" style="font-size: 10pt; color: #000000; background: transparent">
    <TD width="2%" style="background: transparent">&nbsp;</TD>
    <TD width="3%" nowrap align="left"><B>c.</B></TD>
    <TD width="1%">&nbsp;</TD>
    <TD>The premium payments made July 1<SUP style="font-size: 85%; vertical-align: text-top">st</SUP>, 2006 to October&nbsp;31, 2006, will
be adjust to reflect the difference between that interim rate and this final agreed
premium rate. The stop-loss for the 4&nbsp;months period will be $5,500.00.</TD>
</TR>

<TR>
    <TD style="font-size: 6pt">&nbsp;</TD>
</TR><TR valign="top" style="font-size: 10pt; color: #000000; background: transparent">
    <TD width="2%" style="background: transparent">&nbsp;</TD>
    <TD width="3%" nowrap align="left"><B>d.</B></TD>
    <TD width="1%">&nbsp;</TD>
    <TD>For the period beginning November 1<SUP style="font-size: 85%; vertical-align: text-top">st</SUP>, 2006 to September&nbsp;30, 2007 a
different rate will be negotiated between the parties in accordance with the new
coverage that will become effective on November 1<SUP style="font-size: 85%; vertical-align: text-top">st</SUP>, 2006.</TD>
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<DIV style="font-family: 'Times New Roman',Times,serif">
<DIV align="left" style="font-size: 10pt; margin-top: 6pt"><B>The present amendments take precedence and shall prevail over any remaining sections and articles
of the contract which are maintained but could conflict with these amendments.</B>
</DIV>

<DIV align="left" style="font-size: 10pt; margin-top: 6pt">This being the amendment that the parties have agreed to, each party places its initials at the
margin of each of the pages contained herein, and affixes below its signature. In San Juan, Puerto
Rico, on this <B>31&nbsp;day of October, 2006.</B>
</DIV>

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    <TD valign="top"><DIV style="margin-left:0px; text-indent:-0px">/s/ MINERVA RIVERA, ESQ
<DIV style="font-size: 1pt; border-top: 1px solid #000000">&nbsp;</DIV>
<B>MINERVA RIVERA, ESQ</B>
</DIV></TD>
    <TD>&nbsp;</TD>
    <TD align="left" valign="top">&nbsp;</TD>
</TR>
<TR valign="bottom">
    <TD valign="top"><DIV style="margin-left:0px; text-indent:-0px"><B>Executive Director</B></DIV></TD>
    <TD>&nbsp;</TD>
    <TD align="left" valign="top">&nbsp;</TD>
</TR>
<TR valign="bottom">
    <TD valign="top"><DIV style="margin-left:0px; text-indent:-0px"><B>Puerto Rico Health Insurance Administration</B></DIV></TD>
    <TD>&nbsp;</TD>
    <TD align="left" valign="top">&nbsp;</TD>
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    <TD valign="top"><DIV style="margin-left:0px; text-indent:-0px">&nbsp;</DIV></TD>
    <TD>&nbsp;</TD>
    <TD align="left" valign="top">&nbsp;</TD>
</TR>
<TR valign="bottom">
    <TD valign="top"><DIV style="margin-left:0px; text-indent:-0px">/s/ SOCORRO RIVAS
<DIV style="font-size: 1pt; border-top: 1px solid #000000">&nbsp;</DIV>
<B>SOCORRO RIVAS</B>
</DIV></TD>
    <TD>&nbsp;</TD>
    <TD align="left" valign="top">&nbsp;</TD>
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<TR valign="bottom">
    <TD valign="top"><DIV style="margin-left:0px; text-indent:-0px"><B>Chief Executive Officer</B></DIV></TD>
    <TD>&nbsp;</TD>
    <TD align="left" valign="top">&nbsp;</TD>
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<TR valign="bottom">
    <TD valign="top"><DIV style="margin-left:0px; text-indent:-0px"><B>Triple S, Inc.</B></DIV></TD>
    <TD>&nbsp;</TD>
    <TD align="left" valign="top">&nbsp;</TD>
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    <TD valign="top"><DIV style="margin-left:0px; text-indent:-0px">&nbsp;</DIV></TD>
    <TD>&nbsp;</TD>
    <TD align="left" valign="top">&nbsp;</TD>
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<TR valign="bottom">
    <TD valign="top"><DIV style="margin-left:0px; text-indent:-0px">/s/ LUIS A. MARINI, DMD
<DIV style="font-size: 1pt; border-top: 1px solid #000000">&nbsp;</DIV>
<B>LUIS A. MARINI, DMD</B>
</DIV></TD>
    <TD>&nbsp;</TD>
    <TD align="left" valign="top">&nbsp;</TD>
</TR>
<TR valign="bottom">
    <TD valign="top"><DIV style="margin-left:0px; text-indent:-0px"><B>Chief Executive Officer</B></DIV></TD>
    <TD>&nbsp;</TD>
    <TD align="left" valign="top">&nbsp;</TD>
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<TR valign="bottom">
    <TD valign="top"><DIV style="margin-left:0px; text-indent:-0px"><B>Triple-C, Inc.</B></DIV></TD>
    <TD>&nbsp;</TD>
    <TD align="left" valign="top">&nbsp;</TD>
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