1095B Health Ins Offer & Coverage Employee Copy MDTF5095

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.
  • Model: MDTF5095

Ask a Question

Please Choose:

Add to Cart:

Contact MasterDataDirect.com

  • +1(888)447-3282
  • +1(816)254-6222
  • Independence, MO 64055
  • Email Us

Hours: Monday-Friday 8-5CST

Copyright © 2024 MasterdataDirect - Built by PRO-Webs.net