2017 Laser 1095B ACA Continuation Sheet 741715003

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2017 Laser 1095B ACA Continuation Sheet 741715003

TF5095C

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Meet your reporting requirements under the Affordable Care Act (ACA) by using this form to report employees covered by your health plan. Continuation form is used in addition to 1095B when an employee has more than 6 dependents. 1 filing per sheet; shrinkwrapped in packs of 25. Paper filing due date: to IRS by February 28 / to recipient by January 31. 25,20.99,4.99,50,26.99,4.99,100,32.99,4.99,150,41.99,4.99,200,48.99,4.99 25,20.99,4.99,50,26.99,4.99,100,32.99,4.99,150,41.99,4.99,200,48.99,4.99

2017 Laser 1095B ACA Continuation Sheet 741715003

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2017 Laser 1095B ACA Continuation Sheet 741715003
2017 Laser 1095B ACA Continuation Sheet 741715003

Meet your reporting requirements under the Affordable Care Act (ACA) by using this form to report employees covered by your health plan. Continuation ...

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