PreferredOne said an agreement reached this month with health insurance giant Aetna should help the Golden Valley-based health plan compete for business from large companies based in Minnesota.

With the contract between the insurers, large employers with PreferredOne coverage could provide out-of-state workers with access to Aetna's national network of doctors and hospitals.

Blue Cross and Blue Shield of Minnesota has a similar arrangement with other Blue Cross plans, while Medica and HealthPartners have such relationships with national carriers UnitedHealthcare and Cigna, respectively.

The arrangements are important to large multistate employers that "self-insure" their employee health plans, meaning they take the financial risk for claims and hire insurance companies to serve as third-party administrators.

In 2014, nearly 38 percent of Minnesota residents were covered by self-insured employer plans, according to the Minnesota Department of Health.

"We're able to get to some accounts that might not have considered us in the past," said David Crosby, the PreferredOne president and chief executive. Crosby added: "We think that this will be one of the most significant elements … to spur on our growth."

PreferredOne saw dramatic growth in 2014 by way of the state's individual market, where the insurance company suffered big financial losses. As a result, PreferredOne hiked premiums for 2015 and pulled out of the state's MNsure health insurance exchange.

The MNsure presence helped PreferredOne gain national notice in 2014, because the insurer sold individual policies at some of the lowest rates on any of the nation's new health insurance exchanges.

The growth and losses prompted PreferredOne to seek a $25 million loan in late 2014 from Fairview Health Services and North Memorial Health Care, two systems that jointly owned the insurer at the time. As part of the deal, Fairview received options to expand ownership, and in January the Minneapolis-based health system became the sole owner of PreferredOne.

With about 335 employees, PreferredOne continues to sell coverage to individuals in the "off-exchange" market, Crosby said. But he said the Aetna agreement signals how the company is maintaining its historic focus on administering self-insured health plans.

"PreferredOne did have a difficult time in the initial implementation of the [Affordable Care Act]," Crosby said, referring to the federal health law that led to the creation of MNsure and brought fundamental changes to the individual market. "Self-insured has always been the lion's share of our enrollment."

PreferredOne did not release financial details about the agreement with Aetna. The local insurer becomes part of a program called "Aetna Signature Administrators," which Aetna said "provides both organizations the opportunity to serve a unique market segment in Minnesota."

Connecticut-based Aetna currently is trying to complete a $34 billion takeover of Kentucky-based Humana, one of two pending deals that would consolidate the nation's five largest health insurers into three companies.

The new contract arrangement should make PreferredOne an option for more large employers, said Christopher Schneeman, an insurance agent with Seven Hills Benefit Partners in St. Paul.

"PreferredOne has got a strong regional network here," Schneeman said. "One of the things that has added complexity for them being competitive with multistate employers is that they've had to put a patchwork of networks together across the country. This Aetna agreement gives them great national scope."

Christopher Snowbeck • 612-673-4744

Twitter: @chrissnowbeck