Meet your reporting requirements under the Affordable Care Act (ACA) by using this form to report employees covered by your health plan. Typically used by payroll companies and smaller companies with self-funded insurance plans. 1 filing per sheet; packaged in quantities of 100. Compatible with laser or inkjet printers. Paper filing due date: to IRS by February 28 / to recipient by January 31.
SIZE: 8 1/2 x 11"
