Description
TF5096 Laser ACA 1095C Employer Provided Health Insurance Size: 8 1/2 x 11" This form is used by employers with 50 or more full-time employees (FTEs) who worked at least one month during the year.Meet your reporting requirements under the...
TF5096 Laser ACA 1095C Employer Provided Health Insurance
Size: 8 1/2 x 11"
This form is used by employers with 50 or more full-time employees (FTEs) who worked at least one month during the year.
Meet your reporting requirements under the Affordable Care Act (ACA) by using this form to report whether employees were offered health insurance.
- 2-sided form
- Black ink imprint
- Laser form - for Pressure Seal please see product TF5507
- Typically used by payroll companies and Applicable Large Employers (ALEs) with 50 or more full-time employees (FTEs) that worked at least one month during the year, that provide health plans.
- For reporting whether or not the employer offered health coverage to employees.
- One page with backer information per form.
- Compatible with laser or inkjet printers.
- This form is not available in multiple copies. You must order for the total number of copies you need (ex. 50 employees - in most cases you will need one copy for the employee, one for the employer, and one for the IRS so you must order quantity 150).
- 100 per pack