Benefits and Features
Meet your reporting requirements under the Affordable Care Act (ACA) by using this form to report employees covered by your health plan.
- Compatible with laser or inkjet printers.
- Paper filing due date: to IRS by February 28 / to recipient by January 31.
- 1 filing per sheet; packaged in quantities of 100.
- Typically used by payroll companies and smaller companies with self-funded insurance plans.