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Tax Form 1095-C Employer-Provided Health Insurance (1095C)

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  • Form 1095-C, Employer-Provided Health Insurance Offer and Coverage

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

2023 Forms available after November 1. Image will be updated upon availability.

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  • 1094 & 1095 Tax Forms ,
  • 1094 & 1095 Tax Forms

    • Tax Form 1095-C Employer-Provided Health Insurance (1095C)

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    Employers with 50+ full time employees must issue this form to their employees and submit to the IRS. Form 1094-C 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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