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Laser 1095B ACA IRS Copy Continuation Sheet Item No. TF5095N     Size: 11" x 8 1/2"

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Laser 1095B ACA IRS Copy Continuation Sheet

Laser 1095B ACA IRS Copy Continuation Sheet Item No. TF5095N

Meet your reporting requirements under the Affordable Care Act (ACA). Use to report employees who are covered under your health plan. 

 

This form is the IRS Copy, in the IRS mandated landscape format. 

 

Continuation form is used in addition to TF1095B when an employee has more than 6 dependents.

 

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