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  • 1095-C Employer Provided Health Insurance Blank w/ Backer - Portrait

1095-C Employer Provided Health Insurance Blank w/ Backer - Portrait

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Picture of 1095-C Employer Provided Health Insurance Blank w/ Backer - Portrait Picture of 1095-C Employer Provided Health Insurance Blank w/ Backer - Portrait
Picture of 1095-C Employer Provided Health Insurance Blank w/ Backer - Portrait
Picture of 1095-C Employer Provided Health Insurance Blank w/ Backer - Portrait
Picture of 1095-C Employer Provided Health Insurance Blank w/ Backer - Portrait
1095-C Employer Provided Health Insurance Blank w/ Backer - Portrait

• Includes 1095-C forms suitable for employee or employer copies
• Portrait format
• Laser cut sheets
• Printed with heat-resistant ink for use with most inkjet and laser printers
• 1 page equals 1 form
• Compatible Envelope is L1013, L1012, L0303 and L0304


This product offers tiered pricing, giving a lower price per form when you increase the quantity ordered. The table below shows pricing for Pack Size = 100.

SKU: L0315
  • *
  • *
$22.95
PRICE BREAKS - The more you buy, the more you save
Quantity1+11+51+
Price$22.95$16.95$14.95
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