Home > ACA Forms - 1094 & 1095 >

1095-B Continuation Form (B1095BCON05)

1095-B Continuation Form (B1095BCON05)

1095-B Continuation Form (B1095BCON05)

Alternative Views:

1095-B Continuation Form

(B1095BCON05)

1095-B Continuation Form
This form is a continuation of form 1095-B which allows for only 6 covered individuals to be listed. Use this form when there are 7 or more covered individuals to be listed on form 1095-B.

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.

Learn About ACA Reporting

Product Code: B1095BCON05

SELECT A QTY

QTY & PRICE (Scroll Down)*:

Description

1095-B Continuation Form

(B1095BCON05)

1095-B Continuation Form
This form is a continuation of form 1095-B which allows for only 6 covered individuals to be listed. Use this form when there are 7 or more covered individuals to be listed on form 1095-B.

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.

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

	1096 Transmittal Form - 1up (B109605)