Most Hawaii state and county workers will see a 30 percent increase in medical insurance rates over the next three years.

The increase applies to 39,500 active employees covered by Hawaii Medical Service Association plans. Premiums will go up 10 percent in January, 9.8 percent in July 2013 and 7.7 percent in July 2014, said Barbara Coriell, administrator for the state Employer-Union Health Benefits Trust Fund (EUTF).

The rise in rates comes on top of an increase in the share of the premium many public workers began paying last month. As of July 1, many state and county workers are paying 50 percent of their total premium, up from 40 percent.

"Everything’s getting more expensive, yet our actual wages and the take-home pay is going down," said Joseph Lichwa, a chemist and analytical lab manager at the University of Hawaii Water Resources Research Center, whose share of health premiums rose to $500 from $400 last month for a two-party plan. "It’s just another increase. Just all these little increases here and there and at the grocery store and everywhere, it’s hard to keep up with it."

The $500 premium Lichwa is now paying will climb to $650 by July 2014 under the new HMSA rates.

HMSA declined to comment on the new premiums.

Premiums could also rise for 11,500 state and county workers insured by Kaiser Permanente Hawaii, but those changes have not been finalized, Coriell said.

Meanwhile, premiums will decrease on average about 5 percent for 33,000 public worker retirees for one year, starting in January, Coriell said.

The state budgeted for an 11 percent increase in insurance premiums for active workers for 2012 but is raising rates 10 percent for an 18-month period — six months longer than the typical year, said Coriell.

"If you don’t have to look at the next rate increase for six months, that’s a big savings, Coriell said.

The Employer-Union Health Benefits Trust Fund, which administers health and other benefits for about 200,000 active and retired public workers and their dependents, has changed from self-insured preferred provider plans with Hawaii Medical Service Association and HMA Inc. to fully insured plans solely with HMSA.

The fully insured agreement caps costs to EUTF and makes HMSA responsible for paying all claims even if it exceeds the cap. The state’s largest health insurer has also agreed to refund any surplus to EUTF if medical costs are lower than anticipated.

Under the previous self-insured contract, the EUTF was responsible to pay all member claims.

The agency also said it changed its pharmacy benefit manager for prescription drug coverage to CVS Caremark, parent company of Longs Drugs Stores, from Informed RX. The change is expected to save the state about $24 million in the first year.