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| B95BFPREC05 |
| Use this pre-printed laser form for printing form 1095-B. |
Use this pre-printed laser form for printing form 1095-B. Folding perforation at 5 ½. Full page form with instructions printed on the back. 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.
Order one sheet per employee.
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