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Blank 1095 14" EZ Fold - 3.0" Mailer Portion


Use this blank pressure seal form for printing forms 1095-B and 1095-C. Use your pressure seal equipment to fold and seal so the form will be ready to mail. Order by number of sheets. 

A 1095-B form must be issued by a self-insured employer with less than 50 full-time employees (including full-time equivalent employees), or by the insurer to employees and to the IRS as proof of healthcare coverage. 

A 1095-C form must be issued by employers with 50+ full time employees (including full-time equivalent employees) to employees and the IRS. 

Construction: Pressure Seal
Form: 1095
Pages: 1
Size: 8 1/2" x 14"
Horizontal Perforations: 3/8", 5 1/2", 10 5/8", 11", 11 3/8"

Minimum qty of 25. Order in increments of 25.