Affordable Care Act 1095B Health Coverage Continuation Laser Sheet
Item # AQMQF-XHTHV
Meet your reporting requirements under the Affordable Care Act (ACA) by using this form to report employees covered by your health plan. Continuation forms are used in addition to 1095B forms when an employee has more than 6 dependents. Compatible with laser or inkjet printers. 1 filing per sheet; packaged in quantities of 25. Paper filing due date: to IRS by February 28 / to recipient by January 31. 8 1/2" W x 11" L
Meet your reporting requirements under the Affordable Care Act (ACA) by using this form to report employees covered by your health plan. Continuation forms are used in addition to 1095B forms when an employee has more than 6 dependents. Compatible with laser or inkjet printers. 1 filing per sheet; packaged in quantities of 25. Paper filing due date: to IRS by February 28 / to recipient by January 31. 8 1/2" W x 11" L
White
Legal, Office
Decoration not included in price.
Production Time: 10 to 15 working days
Packaging: Bulk
60018 (Illinois, United States)| Quantity | Your Price (each) |
|---|---|
| 25 | $0.83 |
| 60 | $0.49 |
| 100 | $0.31 |
| 200 | $0.24 |
| 300 | $0.20 |
| 400 | $0.20 |
| Quantity: | 25 | 60 | 100 | 200 | 300 | 400 |
|---|---|---|---|---|---|---|
| Your Price (each): | $0.83 | $0.49 | $0.31 | $0.24 | $0.20 | $0.20 |
Additional charges may apply.
White
Legal, Office
Decoration not included in price.
Production Time: 10 to 15 working days
Packaging: Bulk
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