ACA FORM PS1095BC500BLK, Pressure Seal BLANK, 500/PKG (recipient copy) is used to report the months employees and family members were covered under the health plan. This recipient / employee copy is a Blank Portrait 14" Pressure Seal EZ Fold. Can be used for 1095-B and/or 1095-C, with instructions on the back. 500/package. FREE Shipping.
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