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Preprinted Laser, Multipurpose Top, Quickbooks format - With Lines
Preprinted Laser, Multipurpose Top, Quickbooks format - Unlined
Blank 1-up Top Herringbone Laser Check
Envelope - 1099MISC/1099R/1099DIV/1099B 2Up Double Window
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Affordable Care Act (ACA) Recipient Form (Portrait Style) Self-Insured Employer <50 Employees
Use this pre-printed laser form for printing form 1095-B.

B95BFPREC05

Available in increments of 25
Quantity
Total Percent Off Per Unit
$11.25 0% $0.4500
$15.75 30% $0.3150
$27.00 40% $0.2700
$49.50 45% $0.2475
$90.00 50% $0.2250
$95.65 57.5% $0.1913
$118.13 65% $0.1575
$132.80 70.5% $0.1328
$178.80 73.5% $0.1192
$281.25 75% $0.1125
$506.50 77.5% $0.1013
$945.00 79% $0.0945


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 2023 forms
Use envelope 95DWENV05/95DWENVS05 with the portrait style recipient form.




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