​The Laser Blank ACA Form 1095 W/Backer is designed to meet your reporting requirements under the Affordable Care Act (ACA).​ This versatile form serves as either a 1095B or 1095C depending on your software settings, providing the flexibility needed for comprehensive healthcare coverage reporting.
This blank form comes with a sturdy backer, ensuring that your printed data is protected during handling and storage. The dimensions of the form are 8 1/2 inches by 11 inches, making it compatible with standard laser printers.Â