In 2004, premiums will cost an average of $240 a month per individual for medical, drug and vision coverage and $720 for a family. For workers, the bite will mostly be felt by employers, who pay the bulk of the health care costs.

Janice Head, president of Kaiser, said the only way the health care insurer and provider can pay for facility renovations and construction and buy medical equipment is to make a profit. Last year, Kaiser lost $2.8 million, its first loss in recent history.

Kaiser serves 235,000 people in Hawaii.