1095-C Preprinted Portrait With Instructions

1095-C Employer Provided Health Insurance Offer and Coverage. Use this pre-printed portrait version form to print 1095-C information.  Order by number of employees.  If filing by paper order a similar amount of item number  L1095C forms (official IRS version) for submission to the IRS.  The related transmittal is form 1094-C.

Use companion envelope DWEL95 or DWEL95SS (self-seal) for this form if you plan to mail the 1095-C forms separately to employees.