You have successfully added an item to your cart. View Cart

B95BFPREC05 - Preprinted 1095-B Full Page Recipient Form w/Instructions


Price per item:

Log in for pricing


$ 25
Qty: Order a minimum of 25 and in multiples of 25
! Order in multiples of 25

Preprinted Form 1095-B
Full page with preprinted instructions on back.

Use this preprinted laser form for printing form 1095-B. Folding perforation at 5 ½”. Order by number of sheets needed.

A 1095-B form must be issued by a self-insured employer with less than 50 full-time employees (including full-time equivalent employees), or by the insurer to employees and to the IRS as proof of healthcare coverage.


To order a free sample, please contact us at 1-888-880-0463, or