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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

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"

Because this item is not stocked in our warehouse, processing, transit times and stock availability will vary. If you need your items by a certain date, please contact us prior to placing your order. Expedited shipping availability may vary. We cannot guarantee that this item can be cancelled off of the order or returned once it is placed.

Attention CA Residents:

Attention CA Residents

WARNING:This product can expose you to chemicals including lead, which are known to the State of California to cause cancer, birth defects, or other reproductive harm. For more information, go to www.p65warnings.ca.gov.

  • Made in America

    Made in America

    This item was made in the United States of America.

Resources for
ComplyRight AB1095E50S