Benefits and Features
Meet your reporting requirements under the Affordable Care Act (ACA) by using this form to report whether employees were offered health insurance.
Typically used by payroll companiesand Applicable Large Employers (ALEs) with 50+ employees.
One page with backer information per form;packaged 500 forms per carton.
Paper filing due date:to IRS by February 28 / to recipient by January 31.
Compatible with laseror inkjet printers.