Page 14 - Taxforms

ACA PREPRINTED FEDERAL FORMS

ACA Preprinted Federal Forms

1095 Ordering Information

Order in increments of 25
>> IRS Reporting
Order the official IRS landscape format. Only the OFFICIAL IRS FORMS
official landscape format can be used when
reporting to the IRS. When using the official IRS copy only, purchase 3 forms per employee/
recipient to be used as IRS, Recipient, and Employer file copy .
>> Recipient Reporting 1095-B
Order either the official IRS landscape format Item # Description
or portrait style recipient formats, designed for B1095B05 1095-B Health Coverage
easy printing and mailing. Confirm software B1095BCON05 1095-B Continuation Form
compatibility.
1094-B
Item # Description
>> Employer Reporting (File Copy) B1094B05 1094-B Transmittal of Health Coverage
Order either the official IRS landscape format 1095-B Health
Coverage
or portrait style recipient formats. The employer 1095-C B1095B05
needs to retain a copy of what was filed to Item # Description
the IRS and recipient for their records. B1095C05 1095-C Employer Provided Health Insurance 1095-B Continuation Form
B1095CCON05 1095-C Continuation Form
B1095BCON05
1094-C
Item # Description
B1094C105 1094-C Employer Health Transmittal Page 1
B1094C205 1094-C Employer Health Transmittal Page 2
Form Title Who Uses This Form B1094C305 1094-C Employer Health Transmittal Page 3
B1094CS05 1094-C Employer Health Transmittal Kit — Pages 1-3
1095-B Health Coverage Self-insured employers with less than 50 full-time equivalent employees or the
insurer must issue form 1095-B to the responsible individual and file with the IRS
as proof of healthcare coverage .

1094-B Transmittal of Health This transmittal must accompany each batch of 1095-B forms when filing to
Coverage the IRS . This form is not required when issuing recipient copies .

1095-C Employer Provided Health Employers with 50+ full-time equivalent employees must issue form 1095-C 1095-C Employer
Insurance to employees and file with the IRS as proof of healthcare coverage . Provided Health
Insurance 1095-C Continuation Form
B1095C05 B1095CCON05
1094-C Employer Health This transmittal must accompany each batch of 1095-C forms when filing to
Transmittal the IRS . This form may have up to 3 pages depending on whether or not the
transmittal is being filed as the authoritative transmittal and if the filer is a 1094-B Transmittal of Health Coverage
member of an aggregate ALE group . This form is not required when issuing B1094B05
recipient copies .

1094-B TRANSMITTALS

You need one 1094-B form to summarize
ACA 1095 REPORTING DEADLINES a batch of paper 1095-B forms to the IRS .
Do not use 1094-B forms when e-filing .

Type of Reporting Deadline If you need more than the THREE FREE laser forms we send with
1095 Recipient Reporting January 31 your 1095-B, order #B1094B05 .
1095 Federal Reporting February 28*
*Due date is March 31 if filed electronically 1094-C TRANSMITTALS
You need the 1094-C kit to summarize
each batch of paper 1095-C forms to the
IRS . Do not use 1094-C forms when
e-filing . This kit contains all 3 pages of 1094-C Employer Health Transmittal Kit — Pages 1-3
the transmittal . B1094CS05
If you need more than the THREE FREE laser kits we send with
your 1095-C, order #B1094CS05
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