Three high-ranking executives — President Julio Juliá, Mark Rishell and Javier Magriná — have left Medical Card Systems Inc., the company’s board of directors announced Tuesday.

MCS-HMO, the private company that for the past nine months managed MI Salud health benefits throughout most of the island, presented documentation Monday confirming it is owed $242.6 million in payments and premiums by the Health Services Administration, known as ASES in Spanish.