The state’s two largest health insurers posted mixed results in the fourth quarter but both ended 2012 in the black.

Hawaii Medical Service Association, on the strength of its investments portfolio, had net income last quarter of $5.4 million and $36 million for the year. The insurer’s financial performance was aided by net investment gains of $10.1 million and $25.8 million in the quarter and year, respectively. HMSA has 708,378 members.

Meanwhile, Kaiser Permanente Hawaii lost $600,000 in the quarter but had a profit for the year of $1.7 million during a time when it is undertaking a $320 million expansion, laying off employees and cutting expenses. Kaiser has nearly 226,000 members.

“It is encouraging to see that the health insurers have been able to move on to a more solid financial footing after the difficult recession years,” Hawaii Insurance Commissioner Gordon Ito said today. “With that said, the Insurance Division will continue to look closely at these earnings along with the trend of medical care costs when the insurers request a change in rates and utilization.”