UPDATE 5-UnitedHealth profit meets views, backs '09 outlook

* Q4 EPS of 78 cents, ex-items, matches views

* Maintains 2009 EPS forecast

* Shares up 6.6 percent in morning trading (Adds analyst comments, membership details, updates shares)

By Lewis Krauskopf

NEW YORK, Jan 22 (Reuters) - UnitedHealth Group Inc (UNH.N) posted fourth-quarter profit that met Wall Street targets and backed its 2009 forecast on Thursday, sending shares of the health insurer up 6.6 percent.

Analysts hailed the stable results from the largest U.S. health insurer by market value after a brutal 2008 for the sector, in which many insurers dramatically lowered their initial profit estimates for last year.

Even as the broader market fell, shares of most health insurers rose on the report from UnitedHealth, which kicked off the group's fourth-quarter earnings season.

"Expectations have been low, so the fact that a bellwether is coming up with a quarter in line with consensus is a huge positive," said Ana Gupte, an analyst with Sanford C. Bernstein. "It sets a really positive tone to the earnings season."

Analysts pointed to positive trends for UnitedHealth's Medicare plans for seniors and Medicaid plans for low-income Americans, as well as minimal investment losses, in contrast to rivals.

Company officials also appeared encouraged on a conference call with analysts about improvements with customer service and other aspects of their main commercial business that serves employers, said Sheryl Skolnick, an analyst with CRT Capital Group.

"The commercial managed care business is no worse than expected and may be improving a tad in terms of the qualitative metrics that they discussed," Skolnick said.

Fourth-quarter net income fell to $726 million, or 60 cents per share, from $1.22 billion, or 92 cents per share, a year earlier. The latest quarter includes charge of 18 cents per share for resolving class action litigation related to out-of-network medical services.

Excluding items, earnings were 78 cents a share, matching the analysts' average forecast, according to Reuters Estimates.

Revenue rose 9.6 percent to $20.5 billion.

UnitedHealth's medical care ratio, a key measure of the amount of premium revenue spent on medical costs, worsened to 80.8 percent from 79.9 percent a year ago. Premium rates rose more slowly than medical costs for certain plans for employers and seniors.

However, the ratio was better than the 81.8 percent expected by analysts at Oppenheimer & Co.