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.