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2017 Laser 1094B Transmittal Health Coverage

Item#: Size:
Quantity 25 50 100 150 200
TF5400  1-Part/Original $20.99 $26.99 $32.99 $41.99 $48.99
We recommend this quantity.
1.  Quantity

Benefits and Features

Meet your reporting requirements under the Affordable Care Act (ACA). A Summary Transmittal is required for submitting 1095B forms to the IRS.

  • All 1095B submissions mailed to the IRS

    must be accompanied by a Summary Transmittal form 1094B.
  • 1 filing per sheet;

    shrinkwrapped in packs of 25.
  • Use with 1095B

    submissions only.
  • Compatible with laser

    or inkjet printers.