Despite the tumultuous health-care market and struggling economy, Independence Blue Cross reported 2010 financial results Thursday showing a 2.2 percent profit of $211.2 million after losses in the two preceding years.

Chief financial officer Alan Krigstein credited lower-than-expected increases in health-care costs, streamlined operations, and increased investment income.

"We had a renewed focus on our core insurance businesses, added some new cost-effective health-care plans, and we continued to streamline operations," he said. "We also benefited from lower-medical-cost trends."

The company reduced its staff from about 5,400 employees in 2009 to 4,750 at the end of 2010, Krigstein said. Also, rates were raised last year in anticipation of an upswing in health-care costs that fell short of projections, adding to the bottom line.

The struggling economy had by far the most powerful impact on the company's finances. Revenue overall was down $800 million, from $10.1 billion in 2009 to $9.3 billion in 2010. The company said it covered fewer people in 2010 - 3.1 million compared with 3.3 million at the end of 2009.

Moreover, those who retained health insurance were making less use of it, putting off medical care as they struggled to meet other financial obligations.

"When you have a pecking order in your life of financial priorities, all of a sudden, way down low are going to be going to the doctor and getting health care," Krigstein said.

Despite the challenging economy, the company said, it boosted its surplus, intended to guard against an unanticipated surge in claims or other financial setbacks, from $1.6 billion in 2009 to $1.8 billion in 2010.