"Rising unemployment, swine flu and the threat of health care reform all ganged up on managed care companies in the third quarter and could hurt their performance heading into 2010," the Associated Press reports. Nevertheless, companies reported better third-quarter profits than anticipated and one analyst noted that "they're holding their own in a very, very bad situation." Cigna "reported a third-quarter profit that soared 92 percent, as improving equity markets helped turn around the performance of a discontinued business the insurer maintains but no longer markets." UnitedHealth Group also reported double-digit gains compared with the same quarter in 2008. Insurers also reported losses in enrollment, as companies laid off workers (Murphy, 11/05).