Coverage description
A National Council on Compensation Insurance (NCCI) standard form. The declarations page of the workers compensation policy. It names the insured and policy period, lists the states for Part One and Part Three, sets the employers liability limits and shows the premium basis, which audit can change.
Updated
What the form says
Key clauses from edition A, the latest revision, quoted as filed.
“Part One of the policy applies to the Workers Compensation Law of the states listed here”
WC 00 00 01 A
Which states get workers compensation coverage. Item 3.A decides where the policy pays statutory benefits. A state left out of Item 3.A is reached only through the other states coverage in Item 3.C.
“The limits of our liability under Part Two are”
WC 00 00 01 A
Where the employers liability limits are set. Item 3.B carries three separate employers liability limits: bodily injury by accident each accident, bodily injury by disease policy limit, and bodily injury by disease each employee.
“Part Three of the policy applies to the states, if any, listed here”
WC 00 00 01 A
Which other states are covered. Item 3.C lists the states where coverage starts if the insured begins work there during the policy period. When no state is listed, the policy has no other states coverage.
“is subject to verification and change by audit”
WC 00 00 01 A
Why the premium shown is an estimate. The classifications, payroll and premium in Item 4 are estimates. The final premium is worked out from audited records after the policy ends.
How the form has changed
Only revision A is in general use, and insurers print it in their own layouts, so carrier details and premium lines differ from copy to copy while Items 1 to 4 keep the same order and wording.
Editions
Revision letters as filed, newest first. Filing counts include every state submission that lists the edition.
| Edition | Filings | Companies | States | Filed | Document |
|---|---|---|---|---|---|
| E | 4 | 2 | 4 | Feb 2026 to Feb 2026 | View PDF |
| D | 50 | 17 | 9 | May 2022 to Jun 2026 | View PDF |
| C | 17 | 6 | 4 | Jun 2022 to Aug 2026 | View PDF |
| B | 45 | 24 | 21 | May 2022 to Jun 2026 | View PDF |
| ALatest | 1,228 | 247 | 49 | Nov 2021 to Nov 2026 | View PDF |
| Original | 24 | 24 | 14 | Mar 2022 to Jul 2026 | View PDF |
Where filings record what this form replaced, they name earlier edition A(02/89) and other forms NA, WC 99 00 00, P-56016-A, WC 99 00 01, WC 00 10 01 A, WC 22 00 01, WC 90 10 01 A. Only some filings record replacements.
What the filings show
- Edition in use: in the past 12 months, 125 companies filed edition A and 10 companies filed edition B.
- WC 00 00 00 (Workers Compensation and Employers Liability Insurance Policy) is filed alongside it most often, in 250 of the same filings (19%).
Filed under
Data from admitted P&C filings with state insurance departments, submitted Nov 2021 to Nov 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 WC 00 00 01, out of 87 in total.
| Carrier | Filings | States | Editions, most filed first | Last filed |
|---|---|---|---|---|
| WR Berkley Corporation Group18 group companies filed it, led by Midwest Employers Casualty Company and Berkley Casualty Company | 196 | 46 | AB | Jul 8, 2026 |
| Nationwide Corporation Group11 group companies filed it, led by Freedom Specialty Insurance Company and Scottsdale Indemnity Company | 58 | 36 | AD | Jun 30, 2026 |
| Group 1001 Insurance Holdings Group4 group companies filed it, led by Clear Spring Property and Casualty Company and Clear Spring American Insurance Company | 52 | 42 | A | Mar 18, 2026 |
| BCBS OF MI Group8 group companies filed it, led by United Wisconsin Insurance Company and Star Insurance Company | 49 | 37 | AOriginal | Oct 26, 2026 |
| Cincinnati Financial Group3 group companies filed it, led by The Cincinnati Casualty Company and The Cincinnati Indemnity Company | 49 | 36 | AOriginal | Jun 9, 2026 |
| WCF Insurance Company Group3 group companies filed it, led by WCF Select Insurance Company and WCF National Insurance Company | 48 | 42 | A | Jan 13, 2026 |
| Munich RE Group4 group companies filed it, led by Next Insurance US Company and American Alternative Insurance Corporation | 44 | 35 | ABOriginal | Oct 13, 2026 |
| Brookfield Wealth Solutions Group7 group companies filed it, led by American National Property And Casualty Company and Argonaut Insurance Company | 43 | 19 | AD | Aug 11, 2026 |
| THE Hanover Insurance Group9 group companies filed it, led by Allmerica Financial Alliance Insurance Company and Allmerica Financial Benefit Insurance Company | 42 | 37 | AB | Jun 23, 2026 |
| Omaha National Group2 group companies filed it, led by Omaha National Insurance Company and Sutter Insurance Company | 39 | 37 | A | Aug 27, 2026 |
How the largest insurers handle WC 00 00 01
Groups among the largest workers compensation insurers that filed WC 00 00 01 or their own version in the past five years.
- Hartford Fire & CAS GroupUses WC 00 00 01 in 3 filings
- Travelers GroupUses WC 00 00 01 in 1 filing
- Amtrust Financial Services GroupUses WC 00 00 01 in 7 filings
States
Number of filings that include WC 00 00 01 in each state, Nov 2021 to Nov 2026. Darker states have more filings.
Often filed with
Standard-style form numbers that appear in the same filings most often.
- WC 00 00 00Workers Compensation and Employers Liability Insurance Policy250 filings
- WC 00 04 06Premium Discount Endorsement130 filings
- WC 00 03 08Partners, Officers and Others Exclusion Endorsement127 filings
- WC 00 04 22Terrorism Risk Insurance Program Reauthorization Act Disclosure Endorsement123 filings
- WC 00 03 13Waiver of Our Right to Recover From Others Endorsement120 filings
- WC 00 03 11Voluntary Compensation and Employers Liability Coverage Endorsement119 filings
- WC 00 03 01Alternate Employer Endorsement117 filings
- WC 00 04 21Catastrophe (Other Than Certified Acts of Terrorism) Premium Endorsement117 filings
- WC 00 03 02Designated Workplaces Exclusion Endorsement115 filings
- WC 00 03 05Joint Venture as Insured Endorsement115 filings
Recent filings
Latest filings that include this form number. Filed copies open in FilingFocus.
| Submitted | Company | State | Editions | Tracking number |
|---|---|---|---|---|
| Nov 5, 2026 | Atlantic Charter Insurance Company | PA | A | CHAR-135152191 |
| Oct 30, 2026 | Normandy Insurance Company | KS | A | NYIC-135129753 |
| Oct 30, 2026 | Normandy Insurance Company | NM | A | NYIC-135145090 |
| Oct 26, 2026 | United Wisconsin Insurance Company | DE | A | ACCD-G135120953 |
| Oct 26, 2026 | United Wisconsin Insurance Company | ID | A | ACCD-G135120970 |
| Oct 26, 2026 | United Wisconsin Insurance Company | NC | A | ACCD-G135120976 |
| Oct 26, 2026 | United Wisconsin Insurance Company | OR | A | ACCD-G135120978 |
| Oct 16, 2026 | Alaska National Insurance Company | GA | A | ALNI-134972635 |
| Oct 16, 2026 | CopperPoint Casualty Insurance Companyand 1 more | GA | A | COPP-135128872 |
| Oct 16, 2026 | Pacific Compensation Insurance Company | GA | A | EDIC-135128152 |
| Oct 13, 2026 | Next Insurance US Company | SD | A | NXUS-G135124751 |
| Oct 12, 2026 | United Wisconsin Insurance Company | AL | A | ACCD-G135120947 |
Most filed NCCI WC forms
- WC 00 04 19 Part Five, Premium Amendatory Endorsement
- WC 00 00 00 Workers Compensation and Employers Liability Insurance Policy
- WC 00 04 21 Catastrophe (Other Than Certified Acts of Terrorism) Premium Endorsement
- WC 00 04 06 Premium Discount Endorsement
- WC 00 03 13 Waiver of Our Right to Recover From Others Endorsement
- WC 00 04 22 Terrorism Risk Insurance Program Reauthorization Act Disclosure Endorsement
- WC 00 03 08 Partners, Officers and Others Exclusion Endorsement
- WC 00 03 03 Employers Liability Coverage Endorsement
- WC 00 03 11 Voluntary Compensation and Employers Liability Coverage Endorsement
- WC 00 04 03 Experience Rating Modification Factor Endorsement
- WC 00 04 04 Pending Rate Change Endorsement
- WC 00 03 01 Alternate Employer Endorsement