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Item Number: 1095CIRS

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$214.82 $203.12$195.01$194.37$188.93
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Employers with 50 or more full-time employees have to declare whether they provide health insurance for employees each year at tax time. The 1095-C IRS Employer-Provided Health Insurance and Coverage Form is available in packs of 1,000, with volume discounts as the quantity ordered goes up.

The form is available in landscape orientation, as dictated by the government, and is printed on laser cut sheets that can be fed into inkjet and laser printers so the human resources department can print directly on the form rather than manually filling out a page for each employee by hand. This health coverage form shows whether or not the employer offers 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" forms are printed in Black ink, 100 sheets per Pack.

Brand:TFP Data Systems
Feature 1:Laser cut sheets for Inkjet and Laser printers
Feature 2:Ships in 4-5 business days
Carbonless:No
Claim Type:1095-C
Color:White
Condition:New
Currency:USD
Holes Punched:No
Pre-Printed:Yes
Package Height:11 in
Package Weight:8.50 LB
Package Width:8-1/2 in
Material:Paper
Country of Origin:USA
Manufacturer Part Number:1095CIRS
Number of Forms:300
Number of Items:1000
Perforation:No
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