TF5506 2022 Pressure Seal ACA 1095B Health Coverage 8 1/2 x 14" QTY 500
TF5506 2022 Pressure Seal ACA 1095B Health Coverage
Size: 8 1/2 x 14"
Make your own self-mailer.
Small glue capsules around the edge of forms burst when run through a sealing machine creating a bond, thus creating a self-mailer.
This form is used by insurance carriers for reporting which months the insured and his or her family were covered under the plan.
- 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).
- 2-sided form
- For employers with fewer than 50 full-time employees (FTEs) that worked at least one month during the year, that provide health plans.
- For self-insured employers, with fewer than 50 full-time employees that worked at least one month during the year, that provide health plans.
- Compatible with laser or inkjet printers.
- Pressure Seal Forms - for Laser Form please see product TF5095
- 1 filing per sheet
- 500 per Carton