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TF5095L 2019 Laser 1095B ACA Health Coverage IRS Copy 11 x 8 1/2"

Manufacturer: NEBS
Manufacturer Part No: TF5095L
TF5095L 2019 Laser 1095B ACA Health Coverage IRS Copy
Size: 11 x 8 1/2"

This form is used by employers with 50 or more full-time employees (FTEs) who worked at least one month during the year.
Meet your reporting requirements under the Affordable Care Act (ACA). Use to report employees who are covered under your health plan.

  • Report to IRS in mandated landscape format
  • 1 filing per sheet.
  • Black ink imprint
  • Laser form
  • Typically used by payroll companies and smaller companies with self-funded insurance plans.
  • Compatible with laser or inkjet printers.
  • Packaged in quantities of 100.
  • Paper Filing Due Date: To IRS, February 28 // To Recipient January 31
  • 100% Satisfaction Guarantee
  • Higher quantities are available at discounted prices.
  • Speak to a customer service specialist at 855-5FORMS5 or 855-536-7675. 8AM - 7PM EST Monday - Thursday and 8AM - 5PM EST on Friday.


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$16.20 TF5095L 2019 Laser 1095B ACA Health Coverage IRS Copy 11 x 8 1/2"

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