You would think a new class of high-price weight loss drugs taken by millions of Americans would be a problem for health insurers. After all, they ultimately foot the bill. But it is more complicated than that: Some insurance giants actually stand to profit from the Ozempic craze.

The industry has been calling out the costs of GLP-1 drugs, which are used for both diabetes and obesity. But federally supported Medicare and Medicaid still don’t cover the drugs for obesity, and much of the commercial market is self-insured. In other words, even though your insurance card says “Aetna” or “UnitedHealthcare,” those companies in some cases only act as administrators. That means employers are the ones bearing the risk of runaway costs.