BOSTON (AP) — The four largest health insurers in Massachusetts have reported mixed first-quarter financial results, with two posting income gains, one registering lower earnings, and one reporting a loss.

Each cited unique factors influencing financial performance in the three months ending March 31.

The Boston Globe (http://b.globe.com/YLBWkP ) reports that Harvard Pilgrim Health Care turned in the strongest quarterly results, reporting a net income increase of 150 percent to $8.5 million from $3.4 million in the year-ago period.

First-quarter income at Tufts Health Plan rose from $5.1 million to $5.7 million.

First-quarter net income slipped 6 percent to $28 million a year earlier, at Blue Cross Blue Shield of Massachusetts, the state's largest health insurer.

Fallon Community Health Plan absorbed a $200,000 net loss, down from $4.2 million in net income a year ago.

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Information from: The Boston Globe, http://www.boston.com/globe