1. How do I file a grievance with my Triple-S Advantage plan?

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Triple-S Advantage has a strong commitment to protecting the confidentiality of our members’ sensitive information. We take information privacy very seriously and it is important to us that our members are made fully aware of a potential privacy issue. We have learned that personal information of some of our members, including their name, health plan identification number, date of service in which treatment was provided, and treatment codes describing the service provided was mailed to the wrong address. The Social Security Numbers and date of birth of our members were NOT disclosed as a result of this incident.

On December 5, 2017, Triple-S Advantage discovered that notices sent in November 2017 to health care providers involved in the treatment of our members were mailed to the wrong address. However, we have not received any indication that the information has been accessed or used by an unauthorized individual.

Triple-S Advantage has performed an extensive investigation into why and how their personal information was disclosed. We have taken immediate steps to ensure additional notices to our members and your health care providers are sent to the correct address, such as: correction of the mailing process, completion of testings and sending the letters to the correct address of your provider. The members who may have been affected by this incident will receive first-class mail notices.

We have reported the incident to the required government agency, the Health Insurance administration of Puerto Rico (ASES) and will comply with the evaluation as required by the Office of Civil Rights within the time period established.

We are making an announcement about this incident so that affected Triple-S Advantage members can consider taking action to reduce the chances that their personal information will be misused:

Review Explanation of Benefits notices that you receive from us or your health care providers to make sure that the services reported as provided were received by you. If your Explanation of Benefits reflects services that you did not receive, please contact our Customer Service Call Center immediately.
Make sure that you continue to receive documents that you have normally received regarding your health care services or benefits.

If you or a family member belong to Triple-S Advantage and want additional information about the incident, you may contact our Customer Service Department from Monday through Sunday from 8:00 a.m. to 8:00 p.m. at our toll-free number 1-888-620-1919, TTY users should call 1-866-620-2520 or by e-mail at: moc.e1750537613gatna1750537613vdass1750537613s@ecn1750537613ailpm1750537613ocaap1750537613ih1750537613.

You may also visit our Internet website www.sssadvantage.com for further information.

If you are a Medicare Platino member, you can also contact the Health Insurance Administration of Puerto Rico (ASES) at or Customer and Providers Services Offices (PROBENE) at 1-800-981-2737/1-800-981-ASES from Monday through Friday 8:00 am to 4:30 pm, a Customer Services Representative will assist you. TTY users should call (787) 474- 3389. You can also contact us by email at gro.r1750537613psesa1750537613@dadi1750537613cavir1750537613pedla1750537613icifo1750537613.

Triple-S Advantage sincerely apologize and regret this situation. The privacy and security of our member’s information is very important. We are working hard to strengthen our processes for the benefit and protection of our members.

Please Note: Triple-S Advantage will NOT call or email anyone requesting any personal information as a result of this incident. If you receive an unsolicited call or email that appears to be from Triple-S Advantage, your local hospital or physician office, please do not provide any personal information in response to these calls or emails.

Triple-S Advantage, Inc. complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. Triple-S Advantage, Inc. cumple con las leyes federales aplicables de derechos civiles y no discrimina por razón de raza, color, origen de nacionalidad, edad, discapacidad, o sexo. Triple-S Advantage Inc. 遵守適用的聯邦民權法律規定，不因種族、膚色、民族血統、年齡、殘障或性別而歧視任何人ATTENTION: If you speak English, language assistance services, free of charge, are available to you. Call: 1-888-620-1919 (TTY: 1-866-620- 2520). ATENCIÓN: Si usted habla español, servicios de asistencia lingüística están disponibles libre de cargo para usted. Llame al: 1-888-620-1919 (TTY: 1-866-620-2520). 注意:如果您使用繁體中文，您可以免費獲得語言援助服務。請致電 1-888-620-1919 (TTY: 1-866-620-2520)。

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1. How do I file a grievance with my Triple-S Advantage plan?

Member Service

1-888-620-1919

TTY/TDD users

1-866-620-2520

Service for Providers

1-855-886-7474

TeleConsulta

1-800-255-4375

TeleConsejo

1-877-879-5964

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