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1094-C Laser Transmittal:
1094-C Laser Transmittal
Item #: TF5500
Form to submit information about individuals who enroll in a qualified health plan through the Health Insurance Marketplace.

QuantityPriceSavings
25$49.50-
50$62.2537%
100$75.7562%
200$114.0071%
500$239.2576%


Product Details
  • Form consists of 3 pages, 2 sided, black/black
  • combined pages 2 & 3 into one backer
  • Use for summary transmittal record for form 1095-C
  • Issued by: employers. Accompanies 1095-C when mailed to IRS.



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