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2017 Laser 1095B ACA Continuation Sheet

Item#: Size:
Quantity 25 50 100 150 200
TF5095C  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) by using this form to report employees covered by your health plan.

  • Continuation form is used in addition to 1095B

    when an employee has more than 6 dependents.
  • 1 filing per sheet;

    shrinkwrapped in packs of 25.
  • Paper filing due date:

    to IRS by February 28 / to recipient by January 31.
  • Compatible with laser

    or inkjet printers.