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


W-2c Form - Copy A - Employer Federal (BW2C05)
3up Blank W-2 Forms with 1/2" Side Perf (83634)
5498-SA 3up HSA, Archer MSA, or Medicare Advantage MSA Information - Trustee Copy C (9381)
1099-INT Kit 3pt - Preprinted with Self-Seal Envelope (INTS3E)
AL State Tax Balance Due Envelope - 4-5/8" x 9-1/2" (ALB410)
Double Window Envelope - Self Seal - 3-7/8" x 9-1/8" (E939S)
6" x 9" Blank Tax Filing Envelope with Preprinted Checklist (E100)
Double Window Folder with Side-Staple Tabs and Pocket FLSSWBL
MORTGAGE APPLICATION KIT-PATRIOTIC-LEGAL