1095 Forms
(8 Products)
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TOPS ACA Affordable Care Act Forms, 8 1/2" x 11", 50 Forms/Pack, L1095B
1095-B Health Coverage form used to report health care coverage
1-part
Laser printer compatible
Item # 901-1916790
TOPS ACA Affordable Care Act Forms, 8 1/2" x 11", 25 Forms/Pack, L1094C
1094-C Transmittal for 1095C p.1 form used to report healthcare coverage
1 part laser cut sheet form
Laser printer compatible
Item # 901-1916786
TOPS 2017 ACA Forms, 1094B, 25/Pack, Affordable Care Act (L1094B)
1094-B Transmittal for 1095-B forms used to report healthcare coverage
1-part
Laser printer compatible
Item # 901-1916792
TOPS 2015 ACA Forms, 1095C Blank Face Alternate Format, 2000/Carton, Affordable Care Act, L1095CALTBFBULK
L1095CALTBFBULK - 1095-C Continuation Page Alt Format Blank Face
Laser printer compatible
Printed in black ink
Item # 901-1952517
TOPS 2017 ACA Forms, 1094C Page 2, 25/Pack, Affordable Care Act (L1094CP2)
1094-C Transmittal for 1095C p.2 form used to report healthcare coverage
1-part
Laser printer compatible
Item # 901-1916785
TOPS 2017 ACA Forms, 1095A, 50/Pack, Affordable Care Act (L1095A)
1095-A Health Insurance Marketplace Statement used to report healthcare coverage
1-part
Laser printer compatible
Item # 901-1916789
TOPS 2017 ACA Forms, 1094C Page 3, 25/Pack, Affordable Care Act (L1094CP3)
1094-C Transmittal for 1095C p.3 form used to report healthcare coverage
1-part
Laser printer compatible
Item # 901-1916784
TOPS 2017 ACA Forms, 1095C, 50/Pack, Affordable Care Act, L1095C (L1095C)
1095-C Employer-provided Health Insurance Offer and Coverage for an employer that offers health coverage through an employer-sponsored self-insured health plan must complete Forms 1095-C, Parts 1, 2 and 3, for any employee who enrolls in the health c
overage, whether or not the employee is a full-time employee for any month of the calendar year ...
overage, whether or not the employee is a full-time employee for any month of the calendar year ...
1-part
$5.99
Pack
Currently out of stock.
Item # 901-1916781
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