Insurance carriers will soon issue 2022 Medical Loss Ratio rebates, mandated by the Affordable Care Act. While money back is always useful for employers, there are rules governing what employers may be able to do with it. This alert distinguishes between different types of premium refunds and discounts applicable to fully insured health and welfare plans and addresses what employers can do with them. We will also briefly discuss how the rules differ for refunds and discounts related to self-insured group health plans.