Bulk Laser 1095B ACA Health Coverage

Item#: TF5095B Size: 8 1/2 x 11"

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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 companies

    and 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 laser

    or inkjet printers.