Affordable Care Act Form 1095-B
Affordable Care Act Form 1095-B
Click Images to Enlarge

Quantity
Number of
Lot Price
50 $19.20 
100 $36.60 
200 $64.03 
300 $77.76 
500 $105.77 
1000 $181.25 
>1000 Call us at
1-800-982-3676
or Email Us For Price
Quantity:




Self-insured employers with less than 50 full-time employees, or insurers, must issue this form to employees/recipients and submit to the IRS as proof of healthcare coverage. Form 1094-B is the related transmittal.

Be sure to order enough to give to your employees and submit to the IRS.

There are no templates available for this product


Any tax forms ordered today will ship on Wednesday May 29, 2024 if Ground shipping is chosen
They will ship on Tuesday May 28, 2024 if Express shipping is chosen

Recently Viewed See More

Affordable Care Act 1095 Double Window Envelope (Moisture Seal)

Starting at: $13.75

Burris Ride Release ID Dash - Small  - Sun Shine

Starting at: $44.85

Blank Mailing Label Sheets - Legal Size - LS-Address-14P

Starting at: $169.38

The Ultimate Packing Slip - Layout LS-ULTPS

Starting at: $198.00

Blank Mailing Labels LS-Address

Starting at: $40.33

Integrated Labels for QuickBooks ® LS-QB

Starting at: $40.33