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B95BFPREC05 - Form 1095-B - Full Page (Recipient Copy)

B95BFPREC05 - Form 1095-B - Full Page (Recipient Copy)

B95BFPREC05
Bulk Pricing:
Buy in bulk and save

Bulk discount rates

Below are the available bulk discount rates for each individual item when you purchase a certain amount

  • Buy 2 - 24 and pay only $1.1800 each
  • Buy 25 - 49 and pay only $1.1800 each
  • Buy 50 - 99 and pay only $0.6520 each
  • Buy 100 - 199 and pay only $0.5050 each
  • Buy 200 - 499 and pay only $0.3750 each
  • Buy 500 - 999 and pay only $0.3070 each
  • Buy 1000 - 2499 and pay only $0.2320 each
  • Buy 2500 - 4999 and pay only $0.2080 each
  • Buy 5000 - 200000 and pay only $0.1970 each

Price per item:

$1.18

Total:

$ 25
Qty: Order a minimum of 25 and in multiples of 25
! Order in multiples of 25

Preprinted Form 1095-B. Full page with preprinted instructions on back. 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.

Compatible Envelopes: 95DWENV05 (Moisture Seal) | 95DWENVS05 (Self Seal) 

Specifications:
Construction: Laser Preprinted
Form: 1095-B
Pages: 1
Size: 8 1/2" x 11"
Forms /Sheet: 1up
Horizontal Perforation: 5 1/2"