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Pressure Seal 1095B Health Coverage

    • 2016
    • 500
    • $322.00 $0.64 each
    • 1000
    • $597.00 $0.60 each
    • 2000
    • $1127.00 $0.56 each
    • 3000
    • $1623.00 $0.54 each
    • 4000
    • $2106.00 $0.53 each
    • 5000
    • $2599.00 $0.52 each

Product Specifications

  • Ref.: TF5506
  • Size: 8 1/2" x 14"
  • Form is used by payroll companies and smaller companies with self-funded insurance plans.
  • One filing per sheet
  • packaged in quantities of 500
  • Government approved 20# bond paper.
  • Compatible with laser or inkjet printers.
  • Meets all government and IRS filing requirements
  • Make your own self-mailer. Small glue capsules around the edge of forms burst when run through a sealing machine to create a bond and a self-mailer.
  • Min. Order: 500 Forms

Product Description

This form is used to fulfil reporting requirements under the Affordable Care Act (ACA). Use this form to report employees covered by your health plan. This form is typically used by payroll companies and smaller companies with self-funded insurance plans.

Turnaround Time


Up to 48h + Shipping

Turnaround times above are only estimates. Orders with corrupt artwork, missing fonts, low resolution logos, too much text in the personalization, etc. will be delayed until that issue is resolved.

The processing of your order will only start once the issue has been resolved. Finally, although very rare, issues such as a broken plates can occur and may also delay your order, so please try to plan a printing job well in advance of your deadline.

Orders placed after 2pm will be processed the next business day.

Shipping Destinations


U.S.A. and Canada

Shipping Methods:

UPS (Ground, Second Day Air or Next Day Air)

Shipping charges are calculated based on the final amount of your order, please see our Shipping Chart to find out more.

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