1095-B, Health Coverage, IRS Copy

Please Note:  The IRS has not yet released the 2021 version of the ACA forms (1094/1095).  It is currently estimated that they will release the forms by mid-November, at which point we will update this description and the forms will be available for purchase.  Thank you.

Used by insurance carriers and self-insured employers with fewer than 50 full-time employees to report Affordable Care Act (ACA) information to employees/recipients and to the IRS as proof of healthcare coverage.  For laser or inkjet printers.

• This form is used to file with the IRS
• For employees with more than 6 dependents, order 92636.5095N Continuation form, which can be found in Compatible Products (see below)
• The form used for the Recipient copy and as the Employer copy is 92636.5095, which can be found in Compatible Products (see below)
• One recipient per sheet
• Filing Deadlines: to Recipients by January 31 - to IRS by February 28
• Compatible with Laser Link Tax Preparation Software (Product 95412)

Please contact us if you need quantities other than those listed.  We'd be happy to give you a very competitive quote.  And please also give us the opportunity to meet or beat any other legitimate quotes.

You may also want to review our FAQs for frequently-asked questions about tax forms.