Affordable Care Act Form 1095-B

Click Images to Enlarge

Overview/
Pricing
Templates

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

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 June 03, 2024 if Ground shipping is chosen
They will ship on Friday May 31, 2024 if Express shipping is chosen

Recently Viewed See More

Burris 2UP Note Card Template (with writing) for Microsoft Word

Starting at: $0.00

Fluorescent Label 42UP 2 5/8" x 3/4 " - rounded corners (#3760)

Starting at: $100.62

Fluorescent Label 1UP 8 1/4" x 11" (#1040)

Starting at: $100.62

Fluorescent Label 20UP 4" x 1" with vertical gutter (#3440)

Starting at: $100.62

Fluorescent Label 6UP 4" X 3 1/3" w/1 vertical perf (#1700)

Starting at: $100.62

Burris Blank Cut Note Card Template for Microsoft Word

Starting at: $0.00

The following table shows equivalent weights for different grades of paper.

1095-B weight GSM

GSM	Bond	Text/Book	Cover	Bristol	Index	Tag
0 GSM	0 lb	0 lb	0 lb	0 lb	0 lb	0 lb
60 GSM	16 lb	41 lb	22 lb	27 lb	33 lb	37 lb
64 GSM	17 lb	43 lb	24 lb	29 lb	35 lb	39 lb
75 GSM	20 lb	50 lb	28 lb	34 lb	42 lb	46 lb
80 GSM	21 lb	54 lb	30 lb	36 lb	44 lb	49 lb
90 GSM	24 lb	60 lb	33 lb	41 lb	50 lb	55 lb
100 GSM	27 lb	68 lb	37 lb	45 lb	55 lb	61 lb
105 GSM	28 lb	70 lb	39 lb	49 lb	58 lb	65 lb
110 GSM	29 lb	74 lb	41 lb	50 lb	61 lb	68 lb
120 GSM	32 lb	80 lb	44 lb	55 lb	67 lb	74 lb
135 GSM	36 lb	90 lb	50 lb	62 lb	75 lb	83 lb
148 GSM	39 lb	100 lb	55 lb	67 lb	82 lb	91 lb
150 GSM	40 lb	101 lb	55 lb	68 lb	83 lb	92 lb
163 GSM	43 lb	110 lb	60 lb	74 lb	90 lb	100 lb
165 GSM	43 lb	110 lb	60 lb	74 lb	90 lb	100 lb
170 GSM	45 lb	115 lb	63 lb	77 lb	94 lb	104 lb
176 GSM	47 lb	119 lb	65 lb	80 lb	97 lb	108 lb
190 GSM	51 lb	128 lb	70 lb	86 lb	105 lb	117 lb
199 GSM	53 lb	134 lb	74 lb	90 lb	110 lb	122 lb
203 GSM	54 lb	137 lb	75 lb	93 lb	113 lb	125 lb
216 GSM	58 lb	146 lb	80 lb	98 lb	120 lb	133 lb
244 GSM	65 lb	165 lb	90 lb	111 lb	135 lb	150 lb
250 GSM	66 lb	169 lb	92 lb	114 lb	138 lb	154 lb
253 GSM	67 lb	171 lb	94 lb	115 lb	140 lb	155 lb
264 GSM	70 lb	178 lb	98 lb	120 lb	146 lb	162 lb
271 GSM	72 lb	183 lb	100 lb	123 lb	150 lb	166 lb