This document discusses a case study of a large health insurance provider that used Agile methods for a high-risk, complex project to build a health cost estimator, despite the organization typically using a Waterfall approach. The project involved 5 Scrum teams building the estimator over 3 years with a budget of $8.5 million. Using Agile allowed the project to explore risks in increments, deliver the most important features first, have 4 major releases, and develop a 1 1/2 year product roadmap. As a result, the project was completed on time and budget and received an award, demonstrating how Agile can work for complex, high-risk projects even in mostly Waterfall organizations.