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Blank Pressure Seal 14” EZ Fold 1095 (81650)
Blank Pressure Seal 14” EZ Fold 1095 (81650)
Blank Pressure Seal 14” EZ Fold 1095 (81650)
  

Blank Pressure Seal 14” EZ Fold 1095

(81650)
Use this blank pressure seal form for printing forms 1095-B and 1095-C.
8 ½” x 14” Sheet


A 1095-B form must be issued by a self-insured employer with less than 50 full-time employees (including full-time equivalent employees), or by the insurer to employees and to the IRS as proof of healthcare coverage. c



Product Code: 81650

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Blank Pressure Seal 14” EZ Fold 1095

(81650)
Use this blank pressure seal form for printing forms 1095-B and 1095-C.
8 ½” x 14” Sheet


A 1095-B form must be issued by a self-insured employer with less than 50 full-time employees (including full-time equivalent employees), or by the insurer to employees and to the IRS as proof of healthcare coverage.


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