Coverage description
An Insurance Services Office (ISO) standard form. It adds claims-made umbrella coverage for negligent acts, errors or omissions in administering your employee benefit programs, above a scheduled retained limit and subject to a retroactive date.
How the form has changed
2 changes across 2 revisions, newest first. Each edition is compared with the one before it, using wording from filed copies.
06 26 edition
Jun 2026, compared with 12 19Latest editionThe catch-all part of the employee benefit program definition now covers any other employee benefits program rather than only other similar benefits.
12 19
“Any other similar benefits:”
06 26
“Any other employee benefits program:”
12 19 edition
Dec 2019, compared with 12 07Benefits specified under any underlying insurance policy now count as part of your employee benefit program.
12 07
“Any other similar benefits designated in the”
12 19
“Specified under any policy of "underlying insurance".”
Editions
Edition dates as filed, newest first. Filing counts include every state submission that lists the edition.
| Edition | Filings | Companies | States | Filed |
|---|---|---|---|---|
| 06 26Jun 2026Latest | 23 | 2 | 22 | Sep 2025 to Feb 2026 |
| 12 19Dec 2019 | 58 | 36 | 10 | May 2022 to Aug 2026 |
| 12 07Dec 2007 | 11 | 10 | 4 | May 2022 to Jun 2026 |
2 other edition dates appear in one or two filings each, often carrier-specific versions: 02 19, 09 14.
What the filings show
- Edition in use: in the past 12 months, 27 companies filed the 12 19 edition and 1 company filed 06 26.
- CU 04 12 (Condominiums, Co-ops, Associations – Directors and Officers Liability Coverage) is filed alongside it most often, in 67 of the same filings (71%).
Filed under
Data from admitted P&C filings with state insurance departments, submitted Oct 2021 to Aug 2026, excluding withdrawn and rejected filings. One filing can cover several affiliated companies.
Carriers filing this form
The 10 carrier groups with the most filings that include CU 04 03, out of 21 in total.
| Carrier | Filings | States | Editions, most filed first | Last filed |
|---|---|---|---|---|
| Insurance Services Office, Inc.Advisory Organization | 23 | 23 | 06 2612 07 | Sep 30, 2025 |
| Liberty Mutual GroupState Automobile Mutual Insurance Company | 13 | 3 | 12 1912 07 | Jun 17, 2026 |
| WR Berkley Corporation Group14 group companies filed it, led by Acadia Insurance Company and Continental Western Insurance Company | 9 | 1 | 12 19 | Jun 19, 2026 |
| Nationwide Corporation Group3 group companies filed it, led by Nationwide Agribusiness Insurance Company and Crestbrook Insurance Company | 7 | 2 | 12 1912 07 | Jun 30, 2026 |
| Tokio Marine Holdings Incorporated Group2 group companies filed it, led by Safety National Casualty Corporation and Philadelphia Indemnity Insurance Company | 7 | 3 | 12 1906 26 | Aug 11, 2026 |
| Grange Mutual CAS GroupGrange Insurance Company | 6 | 6 | 12 19 | Mar 26, 2024 |
| Church Mutual GroupChurch Mutual Insurance Company, S.I. | 5 | 2 | 12 19 | Jun 26, 2026 |
| Pharmacists Mutual Group2 group companies filed it, led by Pharmacists Mutual Insurance Company and Chiron Insurance Company | 5 | 2 | 12 19 | Jun 18, 2026 |
| Sompo GroupSompo America Insurance Company | 5 | 1 | 12 19 | Jun 15, 2026 |
| Berkshire Hathaway GroupAmGUARD Insurance Company | 2 | 1 | 12 19 | Jun 10, 2026 |
How the largest insurers handle CU 04 03
Groups among the largest commercial umbrella and excess insurers that filed CU 04 03 or their own version in the past five years.
- Chubb Limited GroupUses CU 04 03 in 1 filing
- WR Berkley Corporation GroupFiles its own version: CL CU 2416 Employee Benefits Liability Coverage (4 states)
- Fairfax Financial GroupFiles its own version: CUZC 0403 Employee Benefits Liability Coverage (1 state)
See more forms
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States
Number of filings that include CU 04 03 in each state, Oct 2021 to Aug 2026. Darker states have more filings.
Often filed with
Standard-style form numbers that appear in the same filings most often.
- CU 04 12Condominiums, Co-ops, Associations – Directors and Officers Liability Coverage67 filings
- CU 22 20Pharmacists – Limited Professional Services Coverage (formerly titled Pharmacists)59 filings
- CU 22 63Pharmacists – Broadened Professional Services Coverage (formerly titled Pharmacists – Broadened Coverage)59 filings
- CU 27 10Extended Reporting Period Endorsement For Employee Benefits Liability Coverage58 filings
- CU 00 01Commercial Liability Umbrella Coverage Form57 filings
- CU 24 30Amendment of Insured Contract Definition56 filings
- CU 04 54Loss Of Electronic Data Resulting From Physical Injury To Tangible Property Liability Coverage – Deletion Of Bodily Injury Exception (formerly titled Loss Of Electronic Data Resulting From Physical Injury To Tangible Property Liability Coverage – Subject To Cyber Incident Exclusion – Deletion Of Bodily Injury Exception)55 filings
- CU 34 22Cannabis Exclusion55 filings
- CU 34 23Cannabis Exclusion With Hemp Exception55 filings
- CU 22 94Professional Liability Exclusion – Computer, Telecommunication, Electronic Data Or Internet Services (formerly titled Professional Liability Exclusion – Electronic Data Processing Services And Computer Consulting Or Programming Services)54 filings
Recent filings
Latest filings that include this form number. Filed copies open in FilingFocus.
| Submitted | Company | State | Editions | Tracking number |
|---|---|---|---|---|
| Aug 11, 2026 | Philadelphia Indemnity Insurance Company | SC | 12 19 | PHLX-135041545 |
| Jun 30, 2026 | Crestbrook Insurance Companyand 1 more | CO | 12 19 | NWPP-135003098 |
| Jun 26, 2026 | Church Mutual Insurance Company, S.I. | CO | 12 19 | CHMU-134995025 |
| Jun 19, 2026 | Acadia Insurance Companyand 4 more | CO | 12 19 | BNIC-134992811 |
| Jun 19, 2026 | Berkley Casualty Companyand 8 more | CO | 12 19 | BNIC-134992815 |
| Jun 19, 2026 | Addison Insurance Companyand 1 more | CO | 12 19 | UNFG-134979875 |
| Jun 18, 2026 | Chiron Insurance Companyand 1 more | CO | 12 19 | PHAR-134991608 |
| Jun 17, 2026 | State Automobile Mutual Insurance Company | CO | 12 19 | STAT-134983370 |
| Jun 17, 2026 | State Automobile Mutual Insurance Company | CO | 12 07 | STAT-134984544 |
| Jun 15, 2026 | Sompo America Insurance Company | CO | 12 19 | SMPJ-134971280 |
| Jun 12, 2026 | WCF National Insurance Company | CO | 12 19 | ADWC-134983294 |
| Jun 12, 2026 | WCF National Insurance Company | CO | 12 19 | ADWC-134983840 |
Most filed ISO CU forms
- CU 34 54 Exclusion - Perfluoroalkyl and Polyfluoroalkyl Substances (PFAS)
- CU 21 86 Exclusion – Access Or Disclosure Of Confidential Or Personal Material Or Information
- CU 00 05 Exclusion - Violation of Law Addressing Data Privacy
- CU 34 56 Exclusion – Cyber Incident
- CU DS 01 Commercial Liability Umbrella Declarations
- CU 21 88 Exclusion - Access Or Disclosure Of Confidential Or Personal Material Or Information (Coverage B Only)
- CU 34 44 Broad Abuse or Molestation Exclusion
- CU 34 55 Exclusion - Electronic Data - Deletion Of Bodily Injury Exception
- CU 22 37 Motor Carrier Endorsement
- CU 21 87 Exclusion - Access Or Disclosure Of Confidential Or Personal Information and Data-Related Liability - Limited Bodily Injury Exception Not Included
- CU 04 02 Loss Of Electronic Data Resulting From Physical Injury To Tangible Property Liability Coverage - Subject To Cyber Incident Exclusion
- CU 04 54 Loss of Electronic Data Resulting From Physical Injury To Tangible Property Liability Coverage - Subject To Cyber Incident Exclusion - Deletion Of Bodily Injury Exception
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