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1094-C


1094-C Employer Health Transmittal Forms

1094-C Transmittal Form that must be filed with form 1095-C. This transmittal form has 3 unique pages.

1094-C Page 1  covers parts I & II

1094-C Page 2  covers part III

1094-C Page 3 covers part IV

 

 

 



Priced by the form set. We are currently shipping 2016 forms. Image may reflect prior year images.


This product has quantity discounts

Use with form 1095-C


1095-C


ACA Employer Provided Health Insurance 50 or More Employees e-Filing

Use these forms to file the Affordable Care Act for 50 or more employees if you will be e-Filing.

ACA reporting is mandatory for the calendar year and is the responsibility of the employer.

1095-C Employer Provided Health - (landscape style) You may print a copy of this form as a hardcopy of your records if you like.  You may mail a copy of this form to each recipient or you may opt to send them the portrait style form described below (Full Page Recipient Form) Note: This Employer Provided Health form is NOT formatted to fit in a double window envelope.

1095-CCON05 Continuation Page -  (landscape style) Used for individual employees that need more than 6 covered individuals listed on their form. 

1095-C Full Page Recipient Form - B95CFPREC05 - (portrait style) You may use this page to mail to the recipients if not using the landscape style form described above.  You may print a copy of this form as a hardcopy for your records if you like.  If you opt to send this portrait style form, mail it in envelope 95DWENV05/DWENVS05.  Instructions are on the back of the form.

Three 1094-C Transmittal Forms (three copies of all three forms) are included with any order of 1095-C forms -- order additional transmittal forms if three is not enough.

 



Priced by the sheet. We are currently shipping 2016 forms. Image may reflect prior years.

ACA 50 Plus Employees e-Filing
1095-C Employer Provided Health B1095C 
1095-C Full Page Recipient Form B95CFPREC05 
Continuation Page B1095CCON 



This product has quantity discounts

Use envelope 95DWENV05/95DWENVS05 with the portrait style recipient form.


B95CFPREC05


Preprinted 1095-C Full Page Form with Instructions
Use this preprinted laser form to protect form 1095-C. Perforated 5 1/2"

Sold by the sheet.


This product has quantity discounts

Use envelope 95DWENV05/95DWENVS05


B95CPERFI05


Blank 1095-C Full Page Form with Instructions on the Back
Use this blank laser form to print Form 1095-C; folding perforation at 5 1/2"
Perforation is not meant to be torn. Order one sheet per employee.

Priced by the sheet. We are currently shipping 2016 forms. Images may reflect prior years.


This product has quantity discounts

Use envelope 95DWENV05/95DWENVS05


1095-B


ACA Forms Health Coverage for Self Insured Employers With Less Than 50 Employees - Paper Filing

Use these forms to file the Affordable Care Act Health Coverage for Self Insured Employers with less than 50 employees if you are reporting with paper forms.

Who is a self insured employer?   Self-insured employers, also known as “self-funded”, control what is covered through a customized plan.  The employer has liability for all claims and pays for each claim.

ACA reporting is mandatory for the calendar year 2015 and is the responsibility of the employer.

1094-B Transmittal Form (landscape style) to be used with Form 1095-B and mailed to the IRS.

1095-B Full Page Recipient Form (portrait style) to be mailed to recipients. See info on landscape style recipient form in next paragraph.  Instructions are on the back of the form.

1095-B Health Coverage Form (landscape style) mail to IRS with 1094-B Transmittal.  You may opt to send a copy of this form to the recipients instead of the portrait style form.  The Health Coverage Form is not formatted so that it will fit in a double window envelope.  You may also wish to order a copy of this form to file for your records. You may need to order 3 sets of this form (for IRS, for recipient, for your file).

1095-B Continuation Page (landscape style) Used if an individual employee needs more than 6 covered individuals listed on their form.

Three 1094-B transmittal forms are included with any order of 1095-B forms --  order additional transmittal forms if three is not enough.


 



Priced by the sheet. We are currently shipping 2016 forms. Image may reflect prior years.

ACA Forms Less Than 50 Employees - Paper filing
1094-B Transmittal of Health Coverage (Landscape) B1094B05 
1095-B a Health Coverage - (Landscape) B1095B05 
1095-B Continuation Form (Landscape) B1095BCON05 
1095-B Full Page Recipient Form (Portrait) B95BFPREC05 



This product has quantity discounts

Use envelope 95DWENV05/95DWENVS05 for portrait style recipient form.


95DWENV05/95DWENVS05


1095 Double Window Envelope

Use this envelope for the portrait style recipient forms of the Affordable Care Act. 

The landscape style forms do not have a companion envelope.

The security tint and cellophane windows ensure privacy of your information.  This envelope is constructed of 24# envelope stock.

 




ENVELOPE SEALING
GUMMED 
SELF SEALING + $0.05 



This product has quantity discounts


B95BFPREC05


Affordable Care Act (ACA) Recipient Form (Portrait Style) Self-Insured Employer <50 Employees
Use this pre-printed laser form for printing form 1095-B. Folding perforation at 5 ˝.  Full page form with instructions printed on the back.  A 1095-B form must be issued by a self-insured employer with less than 50 full-time employees (including full-time equivalent employees), or by the insurer to employees. 
Order one sheet per employee. 


Priced by the sheet. We are currently shipping 2016 forms


This product has quantity discounts

Use envelope 95DWENV05/95DWENVS05 with the portrait style recipient form.


1094-B


1094-B Transmittal Form (Landscape Style)
1094-B transmittal form to be used with Form 1095-B and mailed to the IRS.

Priced by the sheet. We are currently shipping 2016 forms. Images may reflect prior years.


This product has quantity discounts

Use with Form 1095-B


B95BLANK


1095-B or 1095-C Blank Paper
Can be used for both 1095-B or 1095-C. This is a blank paper front and back. NO INSTRUCTIONS are included. Folding; perforated in the center.  Perforation is not meant to be torn.

Priced by the sheet. Se are currently shipping 2016 forms. Images may reflect prior years.


This product has quantity discounts


B95BPERFI05


Blank 1095-B Full Page Form with Instructions on the Back
Use this blank laser form to print Form 1095-B; folding perforation at 5 1/2"
Perforation is not meant to be torn. Order one sheet per employee.

Priced by the sheet. Se are currently shipping 2016 forms. Images may reflect prior years.


This product has quantity discounts

Use envelope 95DWENV05/95DWENVS05


80707


Blank Deposit Tickets
Blank laser deposit slips.  THIS ITEM IS NOT PREPRINTED, if you need your company and bank information preprinted please see our item number 81089114.  Each 8 1/2" x 11" sheet contains one laser deposit ticket.  Use this blank deposit ticket with your accounting software, laser printer and MICR toner to produce complete deposit tickets.  If you are using Quick Books order item number 81089114.




This product has quantity discounts


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