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1095-C, Employer-Provided Health Insurance, Employer/Employee Continuation Copy

Item 92636.5096C, 1095-C, Employer-Provided Health Insurance, Employer/Employee Continuation Copy

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Please Note:  The IRS has not yet released the 2019 final version of the ACA forms (1094/1095).  It is currently estimated that the IRS will release the forms by mid-to-late November.  As soon as they do, we will update this description and the forms will be eligible for purchase.  Thank you.

Used by large employers with more 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 an addendum to the 92636.5096 form and is used as the Recipient copy and the Employer copy for recipients with more than 6 dependents
  • The form used for the Recipient copy and as the Employer copy is 92636.5906, which can be found in Compatible Products (see blelow)
  • The Continuation form used to file with the IRS is 92636.5096N, 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.

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