Laser 1095-C Employer Provided Health Insurance

Meet your reporting requirements under the Affordable Care Act (ACA) by using this form to report whether employees were offered health insurance.

Typically used by payroll companies and Applicable Large Employers (ALEs) with 50+ employees.

Don't forget the compatible envelopes: TF77771

• Item #  TF5096
• Size: 8 1/2 x 11"
• Sold in packages of 100 forms
• Tax Forms per Sheet: One filing per sheet. (With backer information)
• Printer Compalibility: Compatible with laser or inkjet printers
• Use to Report: Whether or not the employer offered health coverage to employees
• Meets all government and IRS filing requirements
• Typically used by payroll companies and Applicable Large Employers (ALEs) with 50+ employees.
•  Don't forget the compatible envelopes: TF77771