The Maui News - Hawai'i's largest health maintenance organization is laying off 20 employees in a streamlining effort. Kaiser Permanente Hawai'i announced last week that it is laying off 20 management and nonunion workers. The company has about 4,400 employees in the state. Kaiser spokeswoman Lori Abe said in an email that the company hopes the affected workers will choose to remain by applying for open positions with the company. Kaiser Permanente Hawai'i reported a $200,000 loss in the second quarter.