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1095-B Form Kit (100 PK)

Report employee health plan coverage information to the IRS


  • Applicable for businesses with employer-sponsored group health plans
  • Applicable for self-insured employers that are not required to send Form 1095-C
  • Prevents penalties ($270 per item) for failing to file and send employee copies
  • Includes a Helpful Tips Guide

  • Due to COVID-19 safety protocols, shipping times for this product are delayed.
    We appreciate your understanding as we work to fill orders as quickly as possible.

    *Orders expected to ship 7 - 10 days after the order is placed*.


    NOTE: ACA deadlines have been extended!

  • Form 1094/1095B/1095C Deadline for Recipient Copies: March 2
  • Form 1094/1095B/1095C Deadline for Paper: March 1
  • Form 1094/1095B/1095C Deadline for Efile: March 31
  • SKU: L0063
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    $76.99
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    Protect your company and your employees by having the proper forms to stay in ACA compliance. The Affordable Care Act (ACA) Employer Shared Responsibility Rule requires employers to file forms 1095-B and 1094-B each year. This convenient ACA Compliance Reporting Forms Kit shields your business from non-compliance fines and ensures employees avoid tax return penalties by verifying that they meet the minimum essential coverage (MEC) requirement.

    Included forms:

    • (200) 1095-B Forms (100 for employer, 100 for employee)
    • (100) 1095-B IRS Copy
    • (3) 1094-B Transmittals
    • (100) gummed envelopes for recipient copies

    Protect your company and your employees by having the proper forms to stay in ACA compliance. The Affordable Care Act (ACA) Employer Shared Responsibility Rule requires employers to file forms 1095-B and 1094-B each year. This convenient ACA Compliance Reporting Forms Kit shields your business from non-compliance fines and ensures employees avoid tax return penalties by verifying that they meet the minimum essential coverage (MEC) requirement.

    Included forms:

    • (200) 1095-B Forms (100 for employer, 100 for employee)
    • (100) 1095-B IRS Copy
    • (3) 1094-B Transmittals
    • (100) gummed envelopes for recipient copies
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