1095-C - Employer-Provided Health Insurance Offer and Coverage Page 1 Tax Software Original - White Duplicate -

Original -  White      Duplicate - Canary     Triplicate - Pink

Accessories include:

Inside Tint

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Current Year Employee instructions are on the back side

1095-C - Employer-Provided Health Insurance Offer and Coverage Page 1 Tax Software Original - White Duplicate -Form 1095 C Employers with 50+ full time equivalent employees must issue form 1095 C to employees and file with the IRS as prof of healthcare coverage. Form 1094 C is the related transmittal sent to the IRS. ALL Covered Individuals need to be listed on Page 2 of the 1095 C. Either order item B1095C205 with this form or order both pages together as a kit with item number B1095C1205. (Approved 2025 version coming soon) Please contact us for other