Description
TF5506 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...
TF5506 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.
- 2-sided form
- 1 filing per sheet.
- Black ink imprint.
- Pressure Seal Forms - for Laser Form please see product TF5095 here.
- 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.
- 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).
- This form is not available in multiple copies.
- 500 per pack