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1095-C Employee Copy:
1095-C Employee Copy
Item #: TF5096
Form to submit information about individuals who enroll in a qualified health plan through the Health Insurance Marketplace.

QuantityPriceSavings
100$28.50-
200$36.0037%
300$42.0051%
400$48.0058%
500$57.0060%
1000$93.0067%


Product Details
  • 2 sided, black/black
  • Issued by: employers with 50 oir more full-time employees (Applicable Large Employers) both insured and self-insured employers with fewer than 50 Fulltime employees, that provide health plans
  • Used for reporting whether or not the employer offered health coverage to employees.



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