The Hawaii Medical Service Association boosted compensation for its chief executive Michael Gold by 19 percent to $1.3 million last year as the state’s top insurer prepared to roll out Obamacare.

Gold was one of four isle health insurance executives who received substantial raises as President Barack Obama’s Affordable Care Act overhauled the insurance industry with new benefit requirements and expanded coverage to an estimated 30 million Americans.

"The executive pay for this organization does not appear to be out of line with organizations of comparable size (with $2.6 billion in annual revenue)," said Linda Lampkin, research director of the ERI Economic Research Institute in Wash­­ing­ton, D.C.

The average compensation for a CEO of a nonprofit health organization with annual revenue between $2 billion and $3 billion is roughly $1 million to $1.1 million, according to ERI.

Gold has been a vocal critic of the state’s troubled health insurance exchange — created to enroll the uninsured — and the fees that came along with the new health care law.

HMSA estimates it will pay $65.4 million in ACA fees this year and withdrew this month from the small-business portion of the Hawaii Health Connector, the online insurance marketplace.

Meanwhile, smaller insurers have also cited higher costs related to the ACA and all have had to modify medical policies to meet the provisions of the law, which included adding drug coverage and other benefits to health plans.

Hawaii Management Alliance Association paid $490,000 to Chairman and CEO John Henry Felix, a 26 percent year-over-year increase, while University Health Alliance boosted compensation by 14 percent for President and CEO Howard Lee to $345,775.

Total compensation for AlohaCare’s CEO John McComas jumped 20 percent to $277,204. Hawaii’s newest insurer, Family Health Hawaii, paid its CEO and former Insurance Commissioner J.P. Schmidt $109,039 in its first year of operations.

Kaiser Permanente Hawaii, the state’s largest health-maintenance organization, was the only insurer that reduced its top executive’s pay. The HMO paid its regional president Janet Liang $746,538 in 2013, a drop of 26 percent.