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Tax Form 1095-B - Health Coverage (1095B)

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Tax Form 1095-B - Health Coverage (1095B)

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  • Form 1095-B, Health Coverage

  • 1 form per sheet (Order by number of forms)

Please note: the 2022 form will ship first week in November.

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    •  Authorized Distributor for ADP®

    Self-insured employers with less than 50 full-time employees, or insurers, must issue this form to employees/recipients and submit to the IRS as proof of healthcare coverage. Form 1094-B is the related transmittal.


    • Pre-printed 1-up laser cut sheet

    • 1 form per sheet (Order by number of forms)

    • Actual Size: 8.5"W x 11"H

    • Compatible with envelope 7777

    • Minimum Order Quantity: 100

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