The Hawaii Medical Service Association, faced with doctors and hospitals seeking higher payments, said it will raise health plan rates by an average of 4.4 percent next year for some of the state's biggest employers.

The increase will affect about 164,000 workers and follows an average 3.4 percent increase this year, said HMSA, the state's No. 1 health insurer.

The hike will take effect in January and will apply mostly to companies with more than 100 employees. The specific rate hike will differ for each company based on healthcare usage.

How the 4.4 percent increase will affect individual workers depends on how each employer divides the cost of premiums.

At Hawaiian Electric Co., for example, plan rates have already been set by negotiation with employee groups and HMSA's rate increase wouldn't be passed along, spokeswoman Lynne Unemori said.

As for the increase itself, "these kinds of cost increases are never easy but we recognize HMSA, like all businesses, is facing increased costs," she said.

The January increase is the first announced by HMSA since the state stopped regulating health-insurance premiums. The law requiring health insurers to get approval for increases expired at the end of June.

HMSA said its 4.4 percent increase is well below the 10 percent average increase nationwide.

Patty Foley, corporate director of human resources for Outrigger Enterprises Inc., operator of the Outrigger and Ohana hotel chains, agreed that premiums are rising faster on the Mainland.

"Generally, Hawai'i healthcare costs are lower," Foley said.

Outrigger has enacted programs to help manage healthcare costs for its 2,800 local employees. That includes free flu shots, offering cholesterol checks and helping employees assess their own wellness, including weight, Foley said.

HMSA said the increase was necessitated by higher healthcare costs.

"We continue to experience pressure from local healthcare providers," Steve Van Ribbink, HMSA chief financial officer, said in a statement. In turn, the higher costs are being factored into the health-plan rates.

HMSA paid hospitals, pharmacies, physicians and others $9 million more per month during the second quarter of this year compared with a year earlier.

Reach Greg Wiles at gwiles@honoluluadvertiser.com.