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TF5096B 2019 Laser ACA 1095C Employer Provided Health Bulk Quantity 8 1/2 X 11"

Manufacturer: NEBS
Manufacturer Part No: TF5096B
TF5096B 2019 Laser ACA 1095C Employer Provided Health Bulk Quantity
Size: 8 1/2 X 11"

Bulk quantity of our standard TF5096.
This form is used for employers with 50 or more full-time employees working at least one month during the year.
Meet your reporting requirements under the Affordable Care Act (ACA) by using this form to report whether employees were offered health insurance.

  • 500 per carton
  • 2-sided form
  • Black ink imprint
  • Laser form - for standard quantities of 1095C see product TF5096 here
  • For employers with more than 50 full-time employees (FTEs) that worked at least one month during the year, that provide health plans.
  • This form is not available in multiple copies.  You must order for the total number of copies you need (ex. 50 employees - in most cases you will need one copy for the employee, one for the employer, and one for the IRS so you must order quantity 150).
  • Compatible with laser or inkjet printers.
  • 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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Starting at $41.40

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$41.40 TF5096B 2019 Laser ACA 1095C Employer Provided Health Bulk Quantity 8 1/2 X 11"

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