Coverage description
A National Council on Compensation Insurance (NCCI) standard form. It extends Part One workers compensation to work in the scheduled states that is subject to the Federal Mine Safety and Health Act, adds that act to the definition of workers compensation law, and rewrites the disease rule for exposure before July 1, 1973.
Updated
What the form says
Key clauses from edition B, the latest revision, quoted as filed.
“This endorsement applies only to work in a state shown in the Schedule and subject to the Federal Mine Safety and Health Act”
WC 00 01 02 B
Which work the endorsement reaches. The schedule lists states rather than locations. Work in a listed state that is subject to the act is affected; other work stays under the policy as written.
“Part One (Workers Compensation Insurance) applies to that work as though that state were shown in Item 3.A. of the Information Page.”
WC 00 01 02 B
Which part of the policy is extended. Only Part One is extended. The endorsement does not mention Part Two, and the policy's employers liability exclusion 8 names this act, so read the two together before assuming employers liability applies to the work.
“The definition of workers compensation law includes the Federal Mine Safety and Health Act”
WC 00 01 02 B
Which compensation law the policy pays. The act, and any amendment to it in effect during the policy period, counts as a workers compensation law the policy pays benefits under.
“when the last exposure occurred prior to July 1, 1973, a claim based on that disease must be first filed against you during the policy period”
WC 00 01 02 B
Which policy answers a disease claim. The endorsement replaces Part One's disease rule. A disease claim belongs to the policy in force on the employee's last day of exposure, but when that exposure ended before July 1, 1973, it belongs to the policy in force when the claim is first filed against you.
How the form has changed
Filed copies carry revision B, the 1-15 edition. The earlier revision A appears only on one group's form lists, with no stored text to compare.
Editions
Revision letters as filed, newest first. Filing counts include every state submission that lists the edition.
| Edition | Filings | Companies | States | Filed | Document |
|---|---|---|---|---|---|
| BLatest | 85 | 59 | 9 | Jan 2022 to Sep 2026 | View PDF |
| A | 5 | 5 | 1 | Mar 2022 to Jun 2026 | View PDF |
Filed by one company only: R (Pinnacol Assurance, 5 filings).
What the filings show
- Edition in use: in the past 12 months, 27 companies filed edition B and 4 companies filed edition A.
- Edition R appears only in filings from Pinnacol Assurance (5 filings in 1 state since Jul 1, 2022), which suggests a carrier-specific version.
- WC 00 04 22 (Terrorism Risk Insurance Program Reauthorization Act Disclosure Endorsement) is filed alongside it most often, in 91 of the same filings (96%).
Filed under
Data from admitted P&C filings with state insurance departments, submitted Nov 2021 to Sep 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 01 02, out of 23 in total.
| Carrier | Filings | States | Editions, most filed first | Last filed |
|---|---|---|---|---|
| Brookfield Wealth Solutions Group4 group companies filed it, led by Argonaut Insurance Company and Argonaut-Midwest Insurance Company | 19 | 1 | B | Jun 4, 2026 |
| AXA Insurance Group5 group companies filed it, led by Greenwich Insurance Company and XL Insurance America, Inc. | 6 | 2 | AB | Jun 23, 2026 |
| Tokio Marine Holdings Incorporated Group2 group companies filed it, led by Safety First Insurance Company and Safety National Casualty Corporation | 6 | 2 | B | May 14, 2025 |
| Intact Financial Group3 group companies filed it, led by Atlantic Specialty Insurance Company and OBI America Insurance Company | 5 | 1 | B | Jun 24, 2026 |
| Pinnacol Assurance | 5 | 1 | R | Jun 18, 2026 |
| RLI Insurance GroupRLI Insurance Company | 5 | 1 | B | Aug 18, 2026 |
| Sompo Group2 group companies filed it, led by Sompo America Fire and Marine Insurance Company and Sompo America Insurance Company | 5 | 1 | B | Jun 15, 2026 |
| State Farm GroupState Farm Fire and Casualty Company | 5 | 1 | B | May 4, 2026 |
| THE Hanover Insurance Group6 group companies filed it, led by Allmerica Financial Alliance Insurance Company and Allmerica Financial Benefit Insurance Company | 5 | 1 | B | Jun 23, 2026 |
| WR Berkley Corporation Group8 group companies filed it, led by Intrepid Casualty Company and Intrepid Insurance Company | 5 | 3 | B | Sep 23, 2024 |
How the largest insurers handle WC 00 01 02
Groups among the largest workers compensation insurers that filed WC 00 01 02 or their own version in the past five years.
- Zurich Insurance GroupUses WC 00 01 02 in 2 filings
States
Number of filings that include WC 00 01 02 in each state, Nov 2021 to Sep 2026. Darker states have more filings.
Often filed with
Standard-style form numbers that appear in the same filings most often.
- WC 00 04 22Terrorism Risk Insurance Program Reauthorization Act Disclosure Endorsement91 filings
- WC 00 04 21Catastrophe (Other Than Certified Acts of Terrorism) Premium Endorsement90 filings
- WC 00 01 06Longshoremen's and Harbor Workers' Compensation Act Coverage Endorsement86 filings
- WC 00 01 09Outer Continental Shelf Lands Act Coverage Endorsement86 filings
- WC 00 01 11Migrant and Seasonal Agricultural Worker Protection Act Coverage86 filings
- WC 00 02 01Maritime Coverage Endorsement86 filings
- WC 00 04 19Premium Due Date Endorsement86 filings
- WC 00 01 04Federal Employers' Liability Act Coverage Endorsement85 filings
- WC 00 01 08Nonappropriated Fund Instrumentalities Act Coverage Endorsement85 filings
- WC 00 03 01Alternate Employer Endorsement84 filings
Recent filings
Latest filings that include this form number. Filed copies open in FilingFocus.
| Submitted | Company | State | Editions | Tracking number |
|---|---|---|---|---|
| Sep 16, 2026 | ZNAT Insurance Company | CT | B | ZICO-135090521 |
| Aug 18, 2026 | RLI Insurance Company | CO | B | RLSC-135057018 |
| Aug 7, 2026 | Motorists Commercial Mutual Insurance Company | WY | B | BSIN-135025946 |
| Jun 30, 2026 | American Casualty Company of Reading, Pennsylvaniaand 5 more | CO | B | CNAB-135003197 |
| Jun 24, 2026 | Atlantic Specialty Insurance Companyand 2 more | CO | B | BEAC-134978198 |
| Jun 23, 2026 | Allmerica Financial Alliance Insurance Companyand 5 more | CO | B | HNVX-134968029 |
| Jun 23, 2026 | AXA XL Insurance Company Americasand 3 more | CO | A | XLAM-134996276 |
| Jun 18, 2026 | Pinnacol Assurance | CO | R | PNCA-134982386 |
| Jun 15, 2026 | Sompo America Fire and Marine Insurance Companyand 1 more | CO | B | SMPJ-134970923 |
| Jun 4, 2026 | Argonaut-Midwest Insurance Company | CO | B | ARGN-134974739 |
| Jun 4, 2026 | Argonaut Insurance Company | CO | B | ARGN-134974742 |
| Jun 4, 2026 | Rockwood Casualty Insurance Company | CO | B | ARGN-134974764 |
Most filed NCCI WC forms
- WC 00 00 01 Information Page
- 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