(Bloomberg) — UnitedHealth Group Inc., the biggest U.S. medical insurer, reported earnings that matched analyst estimates, as higher premiums and a surge in enrollment outweighed rising medical costs.

Fourth-quarter earnings of $1.20 a share met the average of 19 analyst estimates tracked by Bloomberg. Enrollment increased as the Minnetonka, Minn.-based insurer added 6.4 million members after a Brazilian acquisition, according to a company statement last week.

An early flu season spurred doctor visits in December, while some insurers also had predicted Americans would schedule more medical procedures as the economy improved.

The rise in flu cases began in November and reached a high level a month earlier than usual, the Centers for Disease Control and Prevention said this month. As of Jan. 9, about 5.6% of all U.S. doctor visits were for influenza, according to the Atlanta-based agency. The figure was 2.2% percent at the peak of the season last year.

UnitedHealth says medical costs rose 12% in the quarter to $20.8 billion. That was all but matched by an 11% increase in premiums and other revenue to $28.8 billion.

Enrollment in the company’s medical plans jumped by almost a fifth to 40.9 million, with gains in employer-backed plans as well as Medicare and Medicaid.

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