TOPS 1095B Affordable Care Act Tax Form

Affordable Care Act Tax Form is a required form to register health coverage with the Internal Revenue Service. This 1095-B form includes prompts for information about the responsible individual; employer sponsored coverage; issuer or other coverage provider; and covered individuals. It is printed in black ink and is compatible with laser printers.

TOPS 1095B Affordable Care Act Tax Form - 50 Sheet(s) - Legal - 11" x 8 1/2" Sheet Size - White Sheet(s) - Black Print Color - 50 / Pack