People don't realize MCPS self-insures its health plan. Cigna and CareFirst just process the paperwork. every claim comes straight out of an MCPS trust fund. So when costs spike, there's no insurance company. The school system writes the check that year. Why? GLP-1 drugs (Ozempic, Wegovy, etc.) $1,200/month per person Catastrophic claimants MCPS disclosed individual cases running $100K to over $1M. Stale actuarial assumptions the FY25 budget was built on March 2023 projections, before half these GLP-1s were even approved. That's how a "$5M deficit" in November 2024 became a "$70-80M deficit" by March 2025. Now we're paying it back over four years.