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 Monday May 06, 2024 if Ground shipping is chosen
They will ship on Friday May 03, 2024 if Express shipping is chosen

Recently Viewed See More

Burris Jumbo Template for Microsoft Publisher

Starting at: $0.00

Burris Blank 2UP Double Postcard Template for Microsoft Publishe

Starting at: $0.00

Affordable Care Act 1094-B Transmittal Forms

Starting at: $18.30

Burris Blank Utility Template for Microsoft Publisher

Starting at: $0.00

Burris 4X6 Postcard Template for Microsoft Word

Starting at: $0.00

Burris Blank Utility Template (Portrait View) for Microsoft Publ

Starting at: $0.00