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1095-C Employer-Provided Health Insurance Offer and Coverage Form (100 Sheets/Pack)
Item Number: 1095C
Pricing:
| Price per Pack of 100 | 2+ Packs | 5+ Packs | 10+ Packs | 20+ Packs |
| $33.20 | $29.39 | $26.59 | $25.47 | $24.47 |
| Volume Savings | 11.5% | 19.9% | 23.3% | 26.3% |
| Need 30+ Packs? Click here for Pricing | ||||
- Laser cut sSheets for Inkjet and Laser printers
- Ships in 4-5 business days
Need a larger quantity? Click here for a Pack of 500.
Customers also Purchased
Customers also Purchased...
Description:
2024 Employer Provided Health Insurance Offer and Coverage Forms, 100 per pack. This health coverage form shows whether or not the employer offered health coverage to employees. This form is for employers with 50 or more full-time employees. Both insured and self-insured issue 1095-C. 8-1/2" x11", Printed in Black ink. 100 sheets per Pack
Downloads:
Specifications:
| Brand: | ComplyRight | Carbonless: | No | |
|---|---|---|---|---|
| Claim Type: | 1095-C | Color: | White | |
| Condition: | New | Currency: | USD | |
| Holes Punched: | No | Pre-Printed: | Yes | |
| Package Height: | 11 in | Package Weight: | 2.50 LB | |
| Package Width: | 8-1/2 in | Material: | Paper | |
| Country of Origin: | USA | Manufacturer Part Number: | 1095C | |
| Number of Forms: | 250 | Number of Items: | 250 | |
| Perforation: | No | Sheet Size: | 8-1/2 x 11 | |
| Ships in: | 4 to 5 Business Days (Plus time in transit) | Size: | 8-1/2 x 11 in | |
| Style: | Laser cut sheet | Text Color: | Black |
| Brand: | ComplyRight |
|---|---|
| Carbonless: | No |
| Claim Type: | 1095-C |
| Color: | White |
| Condition: | New |
| Currency: | USD |
| Holes Punched: | No |
| Pre-Printed: | Yes |
| Package Height: | 11 in |
| Package Weight: | 2.50 LB |
| Package Width: | 8-1/2 in |
| Material: | Paper |
| Country of Origin: | USA |
| Manufacturer Part Number: | 1095C |
| Number of Forms: | 250 |
| Number of Items: | 250 |
| Perforation: | No |
| Sheet Size: | 8-1/2 x 11 |
| Ships in: | 4 to 5 Business Days (Plus time in transit) |
| Size: | 8-1/2 x 11 in |
| Style: | Laser cut sheet |
| Text Color: | Black |
Reviews:
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4.8
Out of 5.0
Overall Rating
97%
of customers that buyfrom this merchant give
them a 4 or 5-Star rating.
October 19, 2024 by Mark G
“It was great”
September 9, 2024 by Elisabet R (Florida, united states)
“thank you!”
September 4, 2024 by Diana S
“This is the 6th time I have ordered products from them. They are fast and the price is great.”
June 25, 2024 by Debby C
“Easy, fast, and the best way to order medical filing supplies. If help is necessary, their customer service is on it.”
June 19, 2024 by Jose C
“Excelente”
