Aetna ( AET) posted a much wider than expected loss before a big charge for a headcount reduction as the company struggled to align costs and prices. Before the item, the insurer said it lost $84.6 million, or 59 cents per share, compared with a profit of $28.7 million, or 20 cents per share, a year earlier. On that basis, analysts had been predicting a loss of 42 cents a share, according to Thomson Financial/First Call. Aetna's fourth-quarter commercial HMO medical cost ratio, which reflects the amount of premiums that go to medical costs, was 89.7%, compared with 87.2% a year ago. Aetna recorded an after-tax charge of $125 million in the fourth quarter to cover severance and facilities costs stemming from the job cuts announced in December. Including that, Aetna posted a net loss of $187.6 million, or $1.30 cents per share. Health plan membership totaled 17.2 million members at the end of 2001 and declined by 2.2 million from the end of 2000. The company said its health plan membership in January 2002 will reflect a significant decline from the end of 2001, as well as an increase in the proportion of self-insured membership.