Coverage description
A National Council on Compensation Insurance (NCCI) standard form. It extends the policy to work subject to the Outer Continental Shelf Lands Act, treating the scheduled location as a state listed in Item 3.A. of the Information Page and adding that act to the policy's definition of workers compensation law.
Updated
What the form says
Key clauses from edition C, the latest revision, quoted as filed.
“applies only to the work described in Item 4 of the Information Page or in the Schedule as subject to the Outer Continental Shelf Lands Act”
WC 00 01 09 C
Which work the endorsement reaches. Only work described on the Information Page or in the endorsement's schedule as subject to the act is affected. The insured's other operations stay under the policy as written.
“The policy will apply to that work as though the location shown in the Schedule were a state named in Item 3.A. of the Information Page.”
WC 00 01 09 C
Where that work is treated as located. The schedule gives the description and location of the offshore work, and the policy treats that location as one of the states its workers compensation coverage applies to.
“and the Outer Continental Shelf Lands Act (43 U.S.C. Sections 1331 et seq.)”
WC 00 01 09 C
Which compensation law the policy pays. The policy's definition of workers compensation law is replaced to add the act to the state laws in Item 3.A., with any amendments in effect during the policy period. Other federal compensation and occupational disease laws stay outside it.
“exclusion 8, does not apply to work subject to the Outer Continental Shelf Lands Act.”
WC 00 01 09 C
Whether employers liability applies. The policy's employers liability part excludes injury in work subject to the act in its exclusion 8. The endorsement lifts that exclusion for this work, so employers liability applies to it as well.
How the form has changed
Revision C (Ed. 1-15) changes only the statute citation, to 43 U.S.C. Sections 1331 et seq., and the spelling of Workers Compensation Law; its coverage wording matches revision B (Ed. 07-11).
Editions
Revision letters as filed, newest first. Filing counts include every state submission that lists the edition.
What the filings show
- Edition in use: in the past 12 months, 33 companies filed edition C and 4 companies filed edition B.
- WC 00 01 04 (Federal Employers' Liability Act Coverage Endorsement) is filed alongside it most often, in 100 of the same filings (97%).
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 01 09, out of 24 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 | C | Jun 4, 2026 |
| Nationwide Corporation Group3 group companies filed it, led by Crestbrook Insurance Company and National Casualty Company | 10 | 1 | C | Jun 30, 2026 |
| AXA Insurance Group5 group companies filed it, led by Greenwich Insurance Company and XL Insurance America, Inc. | 6 | 2 | BC | 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 | C | May 14, 2025 |
| Intact Financial Group3 group companies filed it, led by Atlantic Specialty Insurance Company and OBI America Insurance Company | 5 | 1 | C | Jun 24, 2026 |
| RLI Insurance GroupRLI Insurance Company | 5 | 1 | C | 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 | C | Jun 15, 2026 |
| State Farm GroupState Farm Fire and Casualty Company | 5 | 1 | C | 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 | C | Jun 23, 2026 |
| WR Berkley Corporation Group8 group companies filed it, led by Intrepid Casualty Company and Intrepid Insurance Company | 5 | 3 | C | Sep 23, 2024 |
How the largest insurers handle WC 00 01 09
Groups among the largest workers compensation insurers that filed WC 00 01 09 or their own version in the past five years.
- Travelers GroupFiles its own version: XC 99 0003 (00) Outer Continental Shelf Lands Act Coverage Endorsement (40 states)
- Amtrust Financial Services GroupUses WC 00 01 09 in 1 filing
States
Number of filings that include WC 00 01 09 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 01 04Federal Employers' Liability Act Coverage Endorsement100 filings
- WC 00 01 08Nonappropriated Fund Instrumentalities Act Coverage Endorsement100 filings
- WC 00 01 06Longshoremen's and Harbor Workers' Compensation Act Coverage Endorsement99 filings
- WC 00 01 01Defense Base Act Coverage Endorsement98 filings
- WC 00 04 22Terrorism Risk Insurance Program Reauthorization Act Disclosure Endorsement96 filings
- WC 00 01 11Migrant and Seasonal Agricultural Worker Protection Act Coverage95 filings
- WC 00 04 19Premium Due Date Endorsement95 filings
- WC 00 04 21Catastrophe (Other Than Certified Acts of Terrorism) Premium Endorsement95 filings
- WC 00 00 00Workers Compensation and Employers Liability Insurance Policy93 filings
- WC 00 02 01Maritime Coverage Endorsement93 filings
Recent filings
Latest filings that include this form number. Filed copies open in FilingFocus.
| Submitted | Company | State | Editions | Tracking number |
|---|---|---|---|---|
| Nov 2, 2026 | AmFed Advantage Insurance Companyand 3 more | WA | C | GREY-135137891 |
| Oct 2, 2026 | AmFed Advantage Insurance Companyand 3 more | CA | C | GREY-135104146 |
| Sep 25, 2026 | AmFed Advantage Insurance Companyand 3 more | MI | C | GREY-135103500 |
| Sep 16, 2026 | ZNAT Insurance Company | CT | C | ZICO-135090521 |
| Aug 18, 2026 | RLI Insurance Company | CO | C | RLSC-135057018 |
| Jun 30, 2026 | American Casualty Company of Reading, Pennsylvaniaand 5 more | CO | C | CNAB-135003197 |
| Jun 30, 2026 | Crestbrook Insurance Companyand 1 more | CO | C | NWPP-135003409 |
| Jun 30, 2026 | National Casualty Company | CO | C | NWPP-135004216 |
| Jun 24, 2026 | Atlantic Specialty Insurance Companyand 2 more | CO | C | BEAC-134978198 |
| Jun 23, 2026 | Allmerica Financial Alliance Insurance Companyand 5 more | CO | C | HNVX-134968029 |
| Jun 23, 2026 | AXA XL Insurance Company Americasand 3 more | CO | B | XLAM-134996276 |
| Jun 15, 2026 | Sompo America Fire and Marine Insurance Companyand 1 more | CO | C | SMPJ-134970923 |
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