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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
  • Must be submitted by February 28 via mail or March 31 electronically
UPC Code:400015412698
View all ComplyRight Employee Management and Compliance Forms

ComplyRight 1095BIRSC Specs

Quantity
100/Pack
Shipping Weight
1 lb.
Length
11 Inches
Width
8 1/2 Inches
Features
Made in America
Language
English
Material
Paper
Shape
Rectangle
Type
Tax Forms

ComplyRight 1095BIRSC Details

Provide essential tax records with this ComplyRight 8 1/2" x 11" 1095-B employee / employer copy of health coverage continuation laser tax form. Required under the Affordable Care Act, this document is a continuation of the first 1095-B form, and 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 a mailing envelope. It is made on laser paper for a crisp finish. Plus, 100 forms per pack are included 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 1095BIRSC

  • Restaurant Recruiting Guide