Amid the herky-jerky rollout of the MNsure exchange, one thing has become crystal clear: Price matters.

PreferredOne, one of the state’s smallest insurance companies, is cleaning up against competitors in signing up new customers, mainly because it offers the lowest premium prices on MNsure — and in the nation.

About six of every 10 Minnesotans shopping for private insurance on the new health exchange have enrolled in a PreferredOne health plan. That far outpaces longtime market leader Blue Cross and Blue Shield of Minnesota, which has signed up 24 percent of MNsure shoppers.

“We didn’t start out thinking we wanted to be the absolutely lowest cost,” PreferredOne CEO Marcus Merz said. “But we did say you’re either in or out. And we decided to be in.”

PreferredOne, based in Golden Valley, is the state’s fifth-largest insurance carrier by revenue. Its outsized gains through MNsure could catapult it into second place in the individual market behind Blue Cross and Blue Shield, which traditionally has written about 70 percent of individual policies statewide through its strong ties with insurance brokers. The company has hired about 50 people to handle the surge of business and now has about 400 employees.

“PreferredOne is likely thinking that this was a successful gambit,” said Allan Baumgarten, a Twin Cities-based independent health care analyst. “If I’m an insurance company CEO, I have a sense that if I can get people signed up in the first year, I’m likely to hold on to them going forward. So maybe it’s worth it for me to gamble a little bit.”

Much of the premium savings from PreferredOne, and many other insurers for that matter, comes from offering consumers a limited network of doctors and hospitals. The jury is still out on how consumers will feel about that as their time under the coverage proceeds. Another question: Will insurers such as PreferredOne have collected enough money to pay for the expenses their customers incur?

“Price is a real driver for enrollment,” said Matthew Eyles, of the Washington, D.C.-based health consulting firm Avalere Health. “The question we need to ask is, ‘What is the population that’s enrolling with these plans, and will there be a disconnect with the premiums they’re collecting and their experience in medical claims?’ We just don’t know yet.”

In an analysis of premium prices by Kaiser Health News, PreferredOne came out the lowest in the nation. A 40-year-old person in the Twin Cities pays $154 a month for a silver plan, while the same plan in Wisconsin costs almost three times as much. A catastrophic PreferredOne plan, available for those under 30, can be purchased for $79 a month.

PreferredOne officials said they’re still learning about their new enrollees, but that they aren’t seeing a lot of “newly insured.”

“We’re getting a lot of families with kids, saying this is a pretty good deal,” Merz said.

For Darlene Richter, new medical coverage was all about price. She has been self-insured for a decade, but switched from Blue Cross to a Preferred­One bronze plan when she realized premiums would be $150 less a month. Even with a $5,000 deductible, it’s $1,700 cheaper than her old policy.

“I have never, ever considered going without insurance coverage,” said Richter, 64, who spent weeks trying to pierce through MNsure’s website last year. “The risks are too high and I need to sleep at night.”

PreferredOne is unique in that it is a partnership of three groups of Twin Cities medical providers. Fairview Health, which operates the University of Minnesota medical center and Amplatz Children’s Hospital, has a 50 percent stake in the insurer. North Memorial Health Care and a physician’s association of more than 4,000 clinicians each have a 25 percent share.

The insurer got its start in 1984 as a preferred provider network and administrator for regional and national insurance carriers. About a decade later PreferredOne moved into selling HMO products to large and small employers. It didn’t start selling commercial products to individuals until 2006.

In Minnesota, most people still get coverage through their employers. About 5 percent of the market, or some 250,000 Minnesotans, buy health insurance on their own. Another 8.1 percent, or 445,000, are uninsured. Those are the consumers MNsure is focused on drawing in before open enrollment ends at the end of the month.

Interest in PreferredOne’s policies has surprised even company insiders, where some started an office pool to guess enrollment.

Of the 122,000 Minnesotans who have enrolled in a plan through MNsure, about 34,000 have bought private plans. That means as the clock ticks on the March 31 end of open enrollment, about 19,700 have purchased a PreferredOne plan.