I just got back from Roatan this past Saturday. I did the online pre-check for immigration. I was asked on the plane if I'd done it online, or if I needed the paper form. Supposedly, the immigration system will pull up your pre-check when they enter your passport number, so they don't have to ask to see anything.
I did still have to fill out the little paper form at the airport when leaving. They didn't check it for anything, just collected it and had me move along to security check.
I did still have to fill out the little paper form at the airport when leaving. They didn't check it for anything, just collected it and had me move along to security check.