Insurers that failed to meet an early guideline of the health reform law are going to issue rebates averaging $127 to certain policyholders, according to estimates from the Kaiser Family Foundation. A provision in the health reform law requires health insurers to spend a percentage of premium payments toward patient care and quality improvement activities, including discounted gym memberships or wellness brochures. Under the law, large employer-sponsored plans must spend 85% of policyholders’ premiums this way, 80% for insurers that cover small businesses and individuals. Insurers that do not meet the requirements must issue a refund. Rebates will vary by state and those ensured through a private employer or a state or local government plan.