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1095-C, Employer-Provided Health Insurance, IRS Copy

Item 92636.5096L, 1095-C, Employer-Provided Health Insurance, IRS Copy

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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 used to file with the IRS
  • For employees with more than 6 dependents, order 92636.5096N Continuation form, which can be found in Compatible Products (see below)
  • The form used for the Recipient copy and as the Employer copy is 92636.5096, 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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Item 92636.5096N, 1095-C, Employer-Provided Health Insurance, IRS Continuation Copy
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Use to report Employer-Provided Health Insurance Offer and Coverage Insurance information as required by the Affordable Care Act (ACA). For laser or inkjet printers.
Item 92636.5500, 1094-C, IRS Transmittal for 1095-C Forms
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Item 92636.5097, 1095-B or 1095-C, Employee Copy, Blank
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