Customers also Purchased
Customers also Purchased...
1095-C Employer-Provided Health Insurance Offer and Coverage Form (100 Sheets/Pack)
Item Number: 1095C
Pricing:
| Price per Pack of 100 | 2+ Packs | 5+ Packs | 10+ Packs | 20+ Packs |
| $31.80 | $28.76 | $26.45 | $25.41 | $24.40 |
| Volume Savings | 9.6% | 16.8% | 20.1% | 23.3% |
| Need 30+ Packs? Click here for Pricing | ||||
- Laser cut sSheets for Inkjet and Laser printers
- Ships in 4-5 business days
Need a larger quantity? Click here for a Pack of 500.
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Customers also Purchased
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Description:
2024 Employer Provided Health Insurance Offer and Coverage Forms, 100 per pack. This health coverage form shows whether or not the employer offered health coverage to employees. This form is for employers with 50 or more full-time employees. Both insured and self-insured issue 1095-C. 8-1/2" x11", Printed in Black ink. 100 sheets per Pack
Downloads:
Specifications:
| Brand: | ComplyRight | Carbonless: | No | |
|---|---|---|---|---|
| Claim Type: | 1095-C | Color: | White | |
| Condition: | New | Currency: | USD | |
| Holes Punched: | No | Pre-Printed: | Yes | |
| Package Height: | 11 in | Package Weight: | 2.50 LB | |
| Package Width: | 8-1/2 in | Material: | Paper | |
| Country of Origin: | USA | Manufacturer Part Number: | 1095C | |
| Number of Forms: | 250 | Number of Items: | 250 | |
| Perforation: | No | Sheet Size: | 8-1/2 x 11 | |
| Ships in: | 4 to 5 Business Days (Plus time in transit) | Size: | 8-1/2 x 11 in | |
| Style: | Laser cut sheet | Text Color: | Black |
| Brand: | ComplyRight |
|---|---|
| Carbonless: | No |
| Claim Type: | 1095-C |
| Color: | White |
| Condition: | New |
| Currency: | USD |
| Holes Punched: | No |
| Pre-Printed: | Yes |
| Package Height: | 11 in |
| Package Weight: | 2.50 LB |
| Package Width: | 8-1/2 in |
| Material: | Paper |
| Country of Origin: | USA |
| Manufacturer Part Number: | 1095C |
| Number of Forms: | 250 |
| Number of Items: | 250 |
| Perforation: | No |
| Sheet Size: | 8-1/2 x 11 |
| Ships in: | 4 to 5 Business Days (Plus time in transit) |
| Size: | 8-1/2 x 11 in |
| Style: | Laser cut sheet |
| Text Color: | Black |
Reviews:
We’re currently collecting product reviews for this item. In the meantime, here are some from our past customers sharing their overall shopping experience:
4.8
Out of 5.0
Overall Rating
97%
of customers that buyfrom this merchant give
them a 4 or 5-Star rating.
December 3, 2025 by Jimmy D
“Love the reminder that it's time to re-order.”
November 6, 2025 by Robin B
“Claire in customer service was wonderful. Got a small issue with availability on the website handled immediately for me.”
November 3, 2025 by Shawn S
“Never have an issue. Always get what I order and quickly as well.”
October 29, 2025 by val p (CA, United States)
“BEEN ORDERING THIS FOR YEARS
NEVER ONCE HAD AN ISSUE.
THANK YOU FOR YOUR FLAWLESS CUSTOMER SERVICE.”
October 13, 2025 by J Andersen (ID, United States)
“Great deal for the project I was working on. Thank you.”
