(Bloomberg) — Aflac Inc. said the Patient and Protection and Affordable Care Act (PPACA) is hurting U.S. insurance sales.

Improving investment results helped fourth-quarter earnings, Aflac (NYSE:AFL) said.

The company is reporting $675 million in net income for the quarter on $5.8 billion in revenue, compared with $581 million in net income on $6.4 billion in revenue for the fourth quarter of 2012.

The U.S. business generated $205 million in pretax operating earnings on $1.4 billion in revenue, compared with $208 million in pretax operating earnings.

New annualized premium sales in Japan fell 33 percent to 32.9 billion yen, compared with a 1.5 percent increase a year earlier.

In the United States, sales decreased 10 percent ,to $397 million compared with a 0.7 percent decline in the same period last year.

“We remain disappointed with sales growth in the United States,” Amos said in the statement.

In part because of “continued low levels of optimism” about the economy, and in part because of concerns about PPACA, small employers have been guarded in their hiring outlook, he said.

Although PPACA contributed to U.S. employer uncertainty, U.S. sales of supplemental medical benefits jumped to $71 million, from $53 million.

Chief Investment Officer Eric Kirsch retreated last year from a plan to allocate more funds to U.S. corporate debt after fluctuations in interest rates hurt a measure of solvency monitored by regulators in Japan.

Realized investment gains added $6 million to profit, compared with losses of $111 million a year earlier.

–Editors: Steven Crabill, Dan Reichl

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