Affordable Care Act Forms
![]() | 1094BT - 1095-B Transmittal Transmittal form for 1095-B Health Coverage Information Returns. Sold in packs of 25 sheets. | ![]() |
![]() | 1094CT - 1095-C Transmittal Transmittal form for 1095-C Employer-Provided Health Insurance Offer and Coverage. Sold in packs of 25 forms/75 sheets. Each form is 3 pages. | ![]() |
![]() | 1095BA - 1095-B IRS Copy A 1095-B IRS Copy A Health Coverage Form for employers with less than 50 full-time employees (accommodates up to 6 covered individuals) with instructions on back. Can also be used as an employee copy. Sold in packs of 50 sheets. One employee per sheet. | ![]() |
![]() | 1095CA - 1095-C IRS Copy 1095-C IRS Copy landscape format Employer-Provided Health Insurance Offer and Coverage Form for employers with 50 or more full-time employees with instructions on back. Sold in packs of 50 sheets. | ![]() |