Benefits and Features
Meet your reporting requirements under the Affordable Care Act (ACA) by using this form to report employees covered by your health plan.
Typically used by payroll companiesand smaller companies with self-funded insurance plans.
1 filing per sheet;packaged 500 forms per carton.
Paper filing due date:to IRS by February 28 / to recipient by January 31.
Compatible with laseror inkjet printers.