1095-B Forms - Pressure Seal 14" EZ

(81651)
Use this preprinted pressure seal form for printing form 1095-B.
8 ½” x 14” Sheet


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.
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Quantity / Unit Price
1 / Free Sample
500 - 999 / $0.3157
1000 - 1999 / $0.2545
2000 - 2999 / $0.2338
3000 - 3999 / $0.2086
4000 - 4999 / $0.195
5000 - 5999 / $0.1831
6000 - 7999 / $0.1735
8000 - 9999 / $0.1635
10000 - 19999 / $0.147
20000+ / $0.1373
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Minimum order of 500
or increments of 500
$000.00