95DWENV05 - Form 1095 Double Window Envelope (Moisture Seal)
Below are the available bulk discount rates for each individual item when you purchase a certain amount
Blank Form 1095-B. Use this blank laser form for printing form 1095-B. Instructions are preprinted on the back. 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. Order by the number of sheets needed.
Note: Please check your software for 1095 Envelope compatibility.
Construction: Laser Blank
Size: 8 1/2" x 11"
Forms /Sheet: 2up
Horizontal Perforation: 5 1/2"