Advisory organization

NCCI workers compensation forms

Active forms
62
Companies filing
420
States
49
Latest filing
Nov 6, 2026

Start with these forms

4 forms

The coverage forms, then the endorsements that contracts and certificates ask for most often. Every form also appears in its group below.

FormTitleLatest editionCarrier groupsStatesLast filed
WC 00 00 00Workers Compensation and Employers Liability Insurance PolicyC7546Nov 5, 2026
WC 00 00 01Information PageA8649Nov 5, 2026
WC 00 03 01Alternate Employer EndorsementA4030Nov 2, 2026
WC 00 03 13Waiver of Our Right to Recover From Others EndorsementOriginal4231Nov 2, 2026

Coverage forms

1 form
FormTitleLatest editionCarrier groupsStatesLast filed
WC 00 00 00Workers Compensation and Employers Liability Insurance PolicyC7546Nov 5, 2026

Declarations and schedules

1 form
FormTitleLatest editionCarrier groupsStatesLast filed
WC 00 00 01Information PageA8649Nov 5, 2026

Endorsements

53 forms
FormTitleLatest editionCarrier groupsStatesLast filed
WC 00 04 21Catastrophe (Other Than Certified Acts of Terrorism) Premium EndorsementF6040Nov 2, 2026
WC 00 04 19Part Five, Premium Amendatory EndorsementA5142Sep 16, 2026
WC 00 04 06Premium Discount EndorsementA4541Nov 2, 2026
WC 00 03 13Waiver of Our Right to Recover From Others EndorsementOriginal4231Nov 2, 2026
WC 00 03 01Alternate Employer EndorsementA4030Nov 2, 2026
WC 00 04 24Audit Noncompliance Charge EndorsementOriginal3826Nov 2, 2026
WC 00 04 03Experience Rating Modification Factor EndorsementOriginal3729Nov 2, 2026
WC 00 04 04Pending Rate Change EndorsementOriginal3725Nov 2, 2026
WC 00 03 03Employers Liability Coverage EndorsementC3625Nov 2, 2026
WC 00 01 06Longshore and Harbor Workers' Compensation Act Coverage EndorsementA3515Nov 2, 2026
WC 00 03 05Joint Venture as Insured EndorsementOriginal3527Nov 2, 2026
WC 00 03 10Sole Proprietors, Partners, Officers and Others Coverage EndorsementOriginal3528Nov 2, 2026
WC 00 03 11Voluntary Compensation and Employers Liability Coverage EndorsementA3527Nov 2, 2026
WC 00 04 25Experience Rating Modification Factor Revision EndorsementOriginal3426Nov 2, 2026
WC 00 04 1490-Day Reporting Requirement, Notification of Change in Ownership EndorsementA3328Nov 2, 2026
WC 00 06 03Benefits Deductible EndorsementOriginal3317Sep 16, 2026
WC 00 03 04Insurance Company as Insured EndorsementOriginal3222Sep 16, 2026
WC 00 04 07Rate Change EndorsementOriginal3225Nov 2, 2026
WC 00 04 12Contingent Experience Rating Modification Factor EndorsementOriginal3226Sep 16, 2026
WC 00 03 09Rural Utilities Service EndorsementB2912Sep 16, 2026
WC 00 01 04Federal Employers' Liability Act Coverage EndorsementA2815Nov 2, 2026
WC 00 02 01Maritime Coverage EndorsementB2711Nov 2, 2026
WC 00 05 03Retrospective Rating Plan Premium Endorsement One-Year PlanD2711Sep 16, 2026
WC 00 01 01Defense Base Act Coverage EndorsementA2613Nov 2, 2026
WC 00 01 08Nonappropriated Fund Instrumentalities Act Coverage EndorsementA2612Nov 2, 2026
WC 00 01 16Notification Endorsement of Pending Law Change to Terrorism Risk Insurance Program Reauthorization Act of 2019Original2638Nov 6, 2026
WC 00 02 03Voluntary Compensation Maritime Coverage EndorsementOriginal2611Nov 2, 2026
WC 00 04 05Policy Period EndorsementOriginal2614Sep 16, 2026
WC 00 03 20Professional Employer Organization (PEO) Extension EndorsementB2511Sep 16, 2026
WC 00 01 09Outer Continental Shelf Lands Act Coverage EndorsementC2410Nov 2, 2026
WC 00 04 08Longshore and Harbor Workers' Compensation Act Rate Change EndorsementOriginal2435Sep 16, 2026
WC 00 05 10Retrospective Rating Plan Premium Endorsement Non-Ratable Catastrophe Element or SurchargeB2410Aug 18, 2026
WC 00 05 11Retrospective Premium Endorsement Short FormOriginal2413Sep 16, 2026
WC 00 05 16Retrospective Rating Plan Premium Endorsement, Large Risk Alternative Rating OptionOriginal2414Sep 16, 2026
WC 00 01 02Federal Mine Safety and Health Act Coverage EndorsementB239Sep 16, 2026
WC 00 05 04Retrospective Rating Plan Premium Endorsement Three-Year PlanD2310Sep 16, 2026
WC 00 05 05Retrospective Rating Plan Premium Endorsement Wrap-Up Construction ProjectD239Aug 18, 2026
WC 00 01 11Migrant and Seasonal Agricultural Worker Protection Act Coverage EndorsementOriginal228Sep 16, 2026
WC 00 05 09Retrospective Premium Endorsement ChangesA2110Sep 16, 2026
WC 00 05 12Retrospective Rating Plan Premium Endorsement One-Year Plan, Multiple LinesD208Aug 18, 2026
WC 00 05 15Retrospective Rating Plan Premium Endorsement, Flexibility OptionsA208Aug 18, 2026
WC 00 03 12Voluntary Compensation and Employers Liability Coverage for Residence Employees EndorsementA197Sep 16, 2026
WC 00 03 14Workers Compensation and Employers Liability Coverage For Residence Employees EndorsementA197Sep 16, 2026
WC 00 03 23Multiple Coordinated Policy EndorsementA198Aug 18, 2026
WC 00 05 14Retrospective Rating Plan Premium Endorsement Wrap-Up Construction Project, Multiple LinesD198Aug 18, 2026
WC 00 05 13Retrospective Rating Plan Premium Endorsement Three-Year Plan, Multiple LinesD188Aug 18, 2026

+ 7 moreSee more forms

Exclusions

6 forms
FormTitleLatest editionCarrier groupsStatesLast filed
WC 00 03 08Partners, Officers and Others Exclusion EndorsementOriginal4128Nov 2, 2026
WC 00 03 02Designated Workplaces Exclusion EndorsementOriginal3630Nov 2, 2026
WC 00 03 15Domestic and Agricultural Workers Exclusion EndorsementOriginal2712Sep 16, 2026
WC 00 03 22Professional Employer Organization (PEO) Client Exclusion EndorsementA2412Aug 18, 2026
WC 00 05 08Retrospective Premium Endorsement Aviation ExclusionOriginal2311Aug 18, 2026
WC 00 03 21Professional Employer Organization (PEO) Exclusion EndorsementA2213Aug 18, 2026

Notices and disclosures

1 form
FormTitleLatest editionCarrier groupsStatesLast filed
WC 00 04 22Terrorism Risk Insurance Program Reauthorization Act Disclosure EndorsementC4632Nov 2, 2026