Hawaii Approves Lower Small Employer Health Rates

The Insurance Division approved revised rate increases for small employer plans after HMSA lowered its requested hike.

Updated on Nov. 13, 2026 in Healthcare

Hawaii Approves Lower Small Employer Health Rates

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The Hawaii Insurance Division approved new health insurance rates for small employer plans in early November 2026. HMSA, which insures most Hawaii workers, reduced its requested increase from about 20% to about 15%, with a final rate of 6.3% for employers with fewer than 50 workers.

Why it matters

Every company providing health coverage for Hawaii employers is raising rates above inflation, and rising care costs are driving the increases. Reviewers found HMSA was overestimating its expected 2027 losses, which led to the reduction.

HMSA's final small employer rate is 6.3%, down from 14.9% before reviewer adjustment and a proposed nearly 20% increase. Approved increases for other insurers range from 6% at Kaiser Permanente to 19.5% at UHA.

The players

HMSA

Hawaii Medical Service Association is a nonprofit health insurer that holds more than 70% of the Hawaii insurance market and insures most Hawaii workers.

Hawaii Insurance Division

The state agency that reviews and approves health insurance rates for insurers operating in Hawaii.

Kaiser Permanente

A large integrated health care provider and insurer that operates in Hawaii and had its rate increase approved at 6%.

UHA

Hawaii's insurer with the largest approved rate increase of 19.5% among those named in the approvals.

The details

The Insurance Division reviewed HMSA's requested increase and determined the insurer was overestimating its expected losses for 2027, leading to a lower approved rate. The approved rates are designed to yield about a 3% insurer profit, and HMSA holds more than 70% of the Hawaii insurance market.

Early November 2026: Hawaii Insurance Division approves the new rates.
November 2026: Open enrollment, when most Hawaii workers sign up for coverage and the increases take effect.

Roadmap

The approval follows the state's review process for small employer plans, in which regulators can reduce an insurer's requested increase when projections appear overstated. Hawaii's outcome shows that every insurer serving the state's employers is still raising rates above inflation, with approved increases ranging from 6% to 19.5%.

Small employers in Hawaii will see their approved health plan rate changes take effect during open enrollment this November. Workers at employers with fewer than 50 employees should expect the approved rate increases to show up in their plan costs.

The takeaway

Compare the rate changes for your own plan during open enrollment, since insurers' approved increases vary widely from 6% to 19.5%. Ask your employer or insurer which rate applies to your group before choosing coverage.