TF5507 2022 Pressure Seal ACA 1095C Employer Provided Health Insurance 8 1/2 x 14" QTY 500
TF5507 2022 Pressure Seal ACA 1095C Employer Provided Health Insurance
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.
Meet your reporting requirements under the Affordable Care Act (ACA) by using this form to report whether employees were offered health insurance.
- 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.
- 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).
- 2-sided form
- Compatible with laser or inkjet printers.
- Pressure Seal Forms - for Laser Form please see product TF5095
- 1 filing per sheet
- 500 per Carton