This form is used to fulfil reporting requirements under the Affordable Care Act (ACA). This blank form with backer can function as 1095B or 1095C when your software prints the entire front side.
Specifications
Product Details
Size: 8 1/2" x 14"
This form with backer functions as 1095B or 1095C
One filing per sheet
Packaged in quantities of 500
Government approved 20# bond paper
Compatible with laser or inkjet printers
Meets all government and IRS filing requirements
Small glue capsules around the edge of forms burst when run through a sealing machine to create a bond and a self-mailer