What does employer health coverage cost in Hawaii?

Hawaii, by the filings

What did regulators approve for Hawaii?

Every figure below comes from the filings insurers submitted to regulators. The 2027 numbers are what regulators approved, not what insurers asked for.

What it means for a Hawaii employer

Your renewal is a number. What are you allowed to change about it?

An approved 10.6% sits below the national median of 14.8%. The market number isn't your number, though. Two Hawaii employers the same size can land 20% apart on the same filings.

The Hawaii-specific read: group plans cost less per member per month here, so a CHOICE Arrangement isn't the obvious lever. What Hawaii does have is out-of-network coverage still on the shelf, which means the door stays open if your census makes the math work.

Where the money actually is at these rates: not the plan type, the design changes inside it. Sourcing 2,000+ medications at a $0 copay for the whole household. Unlimited virtual primary and behavioral care so a $0 visit replaces an urgent care trip. A supplemental layer that pays the employer back every pay period instead of adding a line item.

Those have landed at $2,000+ per employee per year in real client projects, with about $988 per employee per year in new cashflow on top of that and independent of it. About $100K per year for every 50 people. $0 upfront, billed out of savings, live in 30 to 45 days. Same broker, same doctors, same cards.

Compare the 12 plan designs  ·  All 50 states and DC  ·  PPO availability by county  ·  Benchmark your cost

If your Hawaii renewal came back flat instead of 10.6%, what would you put the difference into first?

Results vary by group size, plan design, and utilization.

Sounds concerning? You have options.

So what are the actual options in Hawaii?

Hawaii still has out-of-network coverage on the shelf, so nothing here is closed off. The question isn't whether you have options. It's which one costs less on your census.

Here's the part that isn't anyone's fault. The systems that surface plan options only surface what's already inside them. The marketplace shows you what insurers filed for the marketplace. Your broker shows you the markets their appointments reach. Both are doing their job. Neither one can show you what sits outside it.

99% of the brokers we talk to have never had visibility to our programs. They sit outside their commissioned channels.

Why the ranges are keyed to what you run today and not to a product name: that's how they were measured. Every range above comes from completed client projects, grouped by the employer's starting point. We don't publish a savings percentage next to "level-funding" or "captive" as a category, because nobody measured a category. If you see a number like that anywhere, ask what it was measured on.

$0 upfront. Billed out of savings. Live in 30 to 45 days. Same broker, same doctors, same cards. First-year ROI has landed at 10 to 16x across completed projects.

Compare all 12 plan designs  ·  Benchmark your own cost  ·  Get it priced on your census

If one of these came back at the low end of its range for your Hawaii group, which line in your budget would you want it to pay for first?

Ranges are what we have observed across completed engagements. They are not a guarantee, not a quote, and not an offer of coverage. Your result depends on group size, plan design, census, and utilization.

Questions Hawaii employers ask

How much are health insurance rates going up in Hawaii in 2027?

Regulators approved a median 10.6% increase on marketplace plans in Hawaii for 2027. The national median across all individual market filings is 14.8%. Individual insurer approvals in Hawaii range from 9.0% to 12.3%. Insurers had asked for 11.1%. The employer group figure is still under review, with insurers having requested 16.3%: 2 of 5 group filings are still undecided, so there is no approved group number for Hawaii yet.

Is a PPO available in Hawaii on the marketplace?

Yes. A PPO is filed in all 5 Hawaii counties for 2026, so out-of-network coverage is purchasable statewide. In 18 states no county has a PPO or POS plan at all.

What does a silver plan cost in Hawaii?

The lowest cost silver plan for a 40-year-old non-smoker runs $533 per month for 2026 before any subsidy, and it is the same figure in every Hawaii county. The lowest cost PPO silver plan runs about $695.

Do I have to offer health insurance if I have fewer than 50 employees in Hawaii?

Hawaii is the one state where the answer is yes regardless of size. The Hawaii Prepaid Health Care Act requires employers to provide coverage to anyone working 20 or more hours per week, with no headcount minimum at all. The employee’s share is capped at the lesser of 50% of the premium or 1.5% of their monthly gross earnings, and coverage starts after 4 consecutive weeks of employment. The federal ACA rule, which begins at 50 or more full-time employees, sits on top of that.

What are my options in Hawaii with fewer than 50 employees, and what changes above 50?

Because the state requirement applies at any size, the question in Hawaii is which compliant design fits rather than whether to offer one. Under 50, the designs that carry no headcount minimum are open to you, and the supplemental layers sit on top of whatever you already have. Level-funded generally opens up in the tens of lives. At 50 and above, self-funding, a captive and reference-based pricing come into range, and the federal reporting obligations begin. A MEC-only plan is the cheapest way to clear the larger penalty, and worth comparing against a bronze-level design before you choose it. Hawaii’s Prepaid Health Care rules constrain which arrangements qualify, so a design that works on the mainland may not clear the state test here. That one is worth checking before you commit to it.

What’s my best option in Hawaii?

It depends, and the honest version of that answer is a short list of variables rather than a product. Headcount, your workforce ages, whether anyone is mid-treatment, whether you want your claims data back, and what you can fund per employee, alongside what the state Prepaid Health Care rules allow. The range is wide: shelf-rated guaranteed issue plans, which price everyone the same regardless of age and can run alongside your existing plan rather than replacing it, bundles carrying $0 copays on prescriptions, telehealth and behavioral health, high-deductible designs with first-dollar coverage, and combinations in between. If you’d like a look at your specific situation, you can reach us here.

Do you have people in more than one state?

Hawaii shares no border with another state, so there is no neighbor to price against. These are the states employers with Hawaii staff most often compare it to, on the same filings.

California employer health plan costs  ·  Oregon employer health plan costs  ·  Washington employer health plan costs

All 50 states and DC  ·  PPO availability by county  ·  Plain-English glossary

Where these Hawaii numbers come from

Rate changes are the midpoint of what regulators approved for each insurer in Hawaii, from the CMS rate review service, pulled November 1, 2026. 2 of the 7 Hawaii filings for 2027 are still under review; the rest are final. County premiums are the lowest cost plan per metal level for a 40-year-old non-smoker before any subsidy, from the CMS marketplace plan and rate files for plan year 2026, covering all 5 Hawaii counties.

The marketplace versus group cost comparison uses the 2026 average premium per member per month from the insurers’ own filings on both sides, weighted by enrollment. It is an average across each plan’s enrolled mix, not a same-metal, same-plan-type quote. Plan-type availability counts every marketplace plan filed in every Hawaii county and asks whether any of them is a PPO or POS, because the split that matters is whether a doctor outside the network is covered at all. Off-marketplace plans are counted separately, at state level, from the insurers’ 2026 rate filings.

Nothing here is a quote.