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 Friday May 03, 2024 if Ground shipping is chosen
They will ship on Thursday May 02, 2024 if Express shipping is chosen

Recently Viewed See More

Label 1UP 11x17" - 4 vertical slits crackback (#5000)

Starting at: $142.90

Affordable Care Act 1094-B Transmittal Forms

Starting at: $18.30

LS-3.5BL Template for Microsoft Word

Starting at: $0.00

Color Label 1UP 8 1/2" x 11" -2 vertical slits crackback (#1000)

Starting at: $103.70

Four-of-a-Kind Bright Color Postcards - Sonic Green

Starting at: $44.85

Door Hangers 2 Per Page - Perfed Circle - Baby Blue

Starting at: $37.00