My Account | Login | Checkout

You are not logged in

Enter the search term for the product you are looking for below:

More Options
Select Your software vendor from the list below to show only those products compatible with your software.
Display my previous orders

To repeat a previous order in part or full, click the link above. To purchase or view any of the items you have purchased before, simply select it from the list below.
Tax Forms...
Laser Checks...
Envelopes...
Products for Tax Professionals
Preprinted Checks Entry Form
SecureChecks Quick Product Index
Other Resources
Preprinted Laser, Multipurpose Top, Quickbooks format - With Lines
Preprinted Laser, Multipurpose Top, Quickbooks format - Unlined
Envelope - 1099MISC/1099R/1099DIV/1099B 2Up Double Window
Blank 1-up Top Herringbone Laser Check
Envelope - Dble Window 3 11/16 x 8 7/8 QB
List All products
RSS Feed
Affilate Login
Affilate Information
Affilate Services

Click for Details
ACA Employer Provided Health Insurance 50 or More Employees e-Filing
Affordable Care Act (ACA) Employer Provided Health Insurance 50 or More Employees e-Filing. 

1095-C

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

Available in increments of 25
Quantity
Total Percent Off Per Unit
$9.25 0% $0.3700
$12.95 30% $0.2590
$22.20 40% $0.2220
$40.70 45% $0.2035
$74.00 50% $0.1850
$78.65 57.5% $0.1573
$97.13 65% $0.1295
$109.20 70.5% $0.1092
$147.00 73.5% $0.0980
$231.25 75% $0.0925
$416.50 77.5% $0.0833
$777.00 79% $0.0777


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 2019 forms. Image may reflect prior years.
Use envelope 95DWENV05/95DWENVS05 with the portrait style recipient form.

Please review these other products:
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

 

 

 

click to see more



Customers who bought this item also bought

W3 Transmittal
Use the W-3 laser form to summarize W-2 information for the SSA. You must complete one W-3 form for each employer. Forms are 8 ½ x 11 with no perforations and are required to be preprinted with red scannable ink. Order the quantity equal to the number of employers for which you need to file. Mail with the W-2 Copy A in a batch to the SSA.

click to see more

1096 Transmittal Form
Summary and Transmittal. Use the 1096 form to summarize 1099, 1098 and 5498 information for the IRS. You must complete one 1096 form for each payer. Forms are 8 ½ x 11 with no perforations and are printed with required red scannable ink. Order the quantity equal to the number of payers for which you need to file.

click to see more

Envelope - 1099MISC/1099R/1099DIV/1099B 2Up Double Window
Use this envelope with any 1099-MISC, 1099-DIV, 1099-R or 1099-B 2-up forms, from anywhere! Due to the 1099-MISC format change in 2001, use this envelope instead of the traditional 3-up envelope. The security tint and cellophane windows ensure the privacy of information. This envelope is 5 ¾ " x 8 ¾ ". All 1099 envelopes are constructed of 24# envelope stock.

click to see more

Envelope - W2 1099 4up Double window
Use this envelope with our 4-up Version 1 W-2 forms. If you’re unsure about compatibility, please request a sample. The security tint and cellophane windows ensure the privacy of information. This envelope is 5 ¾” x 8 ¾”. All W-2 envelopes are constructed of 24# envelope stock.

click to see more

Blank W2 4up Form - With Instructions
Use this blank 4-up laser paper for printing condensed employee W-2 forms. Laser generate the complete form with Employee Copies B/C/2/2 (federal/file/state/city). Sheets are 8 ½” x 11” with one horizontal and one vertical perforation, creating a form in each quadrant (version #1), and are constructed of 20# laser paper. This 4-up paper includes employee instructions on back. Order by the number of sheets needed, not number of forms. Envelope compatibility depends on your software.

click to see more





Support




Official PayPal Seal
 

We verify orders.

In addition to standard credit card verification procedures which insure the credit card is not stolen, we also verify the computer IP address, phone numbers, etc., to ensure the person placing the order is not doing so for fraudulent purposes. We work with all applicable agencies to prevent and/or report fraudulent or suspicious activity.

Have Questions? -- Please call us at 1-800-577-4169
Copyright 2010-2017 Secure Checks. All rights reserved.