Home > ACA Forms - 1094 & 1095 >

1095-B Health Coverage (B1095B05)
1095-B Health Coverage (B1095B05)
 

1095-B Health Coverage

(B1095B05)

Affordable Care Act Form 1095-B
1095-B forms are filed with the IRS and supplied to the insured by an insurance company or to the employee by a self-insured employer with fewer than 50 Full Time Equivalent employees.

This official version of the form must be used for filing with the IRS. For employees/insured our recipient copies can be easily folded and mailed in double window envelopes.

If you are using the official version for both IRS and employee/insured, order 2 forms for each insured, if you are simply filing with the official version, order 1 form per employee/insured.

1095-B forms are summarized by a 1094-B transmittal.
Learn About ACA Reporting




Product Code: B1095B05

SELECT A QTY

QTY & PRICE (Scroll Down)*:


Description
 

1095-B Health Coverage

(B1095B05)

Affordable Care Act Form 1095-B
1095-B forms are filed with the IRS and supplied to the insured by an insurance company or to the employee by a self-insured employer with fewer than 50 Full Time Equivalent employees.

This official version of the form must be used for filing with the IRS. For employees/insured our recipient copies can be easily folded and mailed in double window envelopes.

If you are using the official version for both IRS and employee/insured, order 2 forms for each insured, if you are simply filing with the official version, order 1 form per employee/insured.

1095-B forms are summarized by a 1094-B transmittal.
Learn About ACA Reporting


Share your knowledge of this product with other customers... Be the first to write a review

Browse for more products in the same category as this item:

ACA Forms - 1094 & 1095


WI State Tax Envelope for Refunds - #10 (WIR410)
W-2 Set 6-part - Blank Condensed 3up (3UPSET605)
Double Window Envelope - Moisture Seal - 4-1/8" x 9 1/2" - #10 (81553)
Double Window Envelope - Moisture Seal - 3-7/8" x 8-7/8" - #9 (80611)
IN State Tax Envelope for Returns with a Payment - 6" x 9" (INB610)
W-3C Correction Form - 2-part Continuous (W3C052)
1099-R Distributions From Pensions, etc. - Recipient Copies B/C/2 - 3up (BR3UP05)
VT State Tax Envelope for Refund - 6" x 9" (VTR610)
2018 W-2G Winner Record Copy C (18BW2GEEC05)