$44.49/Each

This product is no longer available. We've left this page up for reference only.

Usually Ships in 2 Business Days from manufacturer

Lead times vary based on manufacturer stock

Product Overview

  • Required under the Affordable Care Act
  • Gives the IRS a report on individuals under minimum essential coverage
  • Form provides a copy of the report for employees and employers
  • Issued by insurance carriers and self-insured employers
  • Convenient envelopes and software are included
UPC Code:400015412704
View all ComplyRight Employee Management and Compliance Forms

ComplyRight AB1095E50S Specs

Quantity
25/Each
Shipping Weight
1 lb.
Length
11 Inches
Width
8 1/2 Inches
Color
White
Features
Made in America
Material
Paper
Shape
Rectangle
Type
Tax Forms

ComplyRight AB1095E50S Details

Provide essential tax records with this ComplyRight 1095-B employee/employer copy of health coverage tax form with envelopes and software. Required under the Affordable Care Act, this document gives the IRS a report on individuals under minimum essential coverage. This form provides employers and employees with a copy of this important information.

At a standard 8 1/2" x 11" size, this form can be easily folded down to fit in the included mailing envelope. Software is also included for simple and convenient e-filing. Plus, this set comes with 25 forms per pack for long-lasting use. This form should be submitted by February 28 via mail or March 31 electronically.

Overall Dimensions:
Length: 11"
Width: 8 1/2"

Attention CA Residents:
  • Made in America

    Made in America

    This item was made in the United States of America.

Resources for
ComplyRight AB1095E50S

  • Restaurant Recruiting Guide