Coverage description
A National Council on Compensation Insurance (NCCI) standard form. It treats a named alternate employer as insured under Parts One and Two for injuries to your employees while they are in special or temporary employment with that employer in the scheduled state.
Updated
What the form says
Key clauses from edition A, the latest revision, quoted as filed.
“Part One (Workers Compensation Insurance) and Part Two (Employers Liability Insurance) will apply as though the alternate employer is insured.”
WC 00 03 01 A
Who is treated as insured. The alternate employer gets the protection of both the workers compensation and the employers liability parts of your policy, but only for injuries to your employees during special or temporary employment with it.
“applies only to work you perform under the contract or at the project named in the Schedule”
WC 00 03 01 A · New in this edition
When coverage is limited to one contract or project. Revision A added Item 3 to the schedule. When a contract or project is entered there, the alternate employer is protected only for that work; when it is left blank, the endorsement reaches all special or temporary employment in the scheduled state.
“We will not file evidence of this insurance on behalf of the alternate employer with any government agency.”
WC 00 03 01 A
Why the alternate employer still needs its own coverage. The endorsement says it is not meant to satisfy the alternate employer's own duty to secure workers compensation, and the insurer will not file proof of coverage for it with a state agency.
“The policy may be canceled according to its terms without sending notice to the alternate employer.”
WC 00 03 01 A
Whether the alternate employer is told about cancellation. The insurer owes the alternate employer no notice of cancellation. Notice goes only as the policy's own cancellation condition requires.
How the form has changed
1 change across 1 revision, newest first. Each edition is compared with the one before it, using wording from filed copies.
Edition A
Compared with the original editionLatest editionAdds a contract or project item to the schedule. When it is filled in, the alternate employer's coverage applies only to work under that contract or at that project.
Original edition
Not in this edition
Edition A
“If an entry is shown in Item 3 of the Schedule”
Editions
Revision letters as filed, newest first. Filing counts include every state submission that lists the edition.
| Edition | Filings | Companies | States | Filed | Document |
|---|---|---|---|---|---|
| ALatest | 152 | 93 | 28 | Jan 2022 to Nov 2026 | View PDF |
| Original | 9 | 11 | 4 | May 2023 to Oct 2025 | View PDF |
Where filings record what this form replaced, they name other forms N/A. Only some filings record replacements.
What the filings show
- Edition in use: in the past 12 months, 53 companies filed edition A.
- WC 00 03 02 (Designated Workplaces Exclusion Endorsement) is filed alongside it most often, in 152 of the same filings (95%).
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 03 01, out of 40 in total.
| Carrier | Filings | States | Editions, most filed first | Last filed |
|---|---|---|---|---|
| Nationwide Corporation Group9 group companies filed it, led by AMCO Insurance Company and Crestbrook Insurance Company | 20 | 1 | A | Jun 30, 2026 |
| Brookfield Wealth Solutions Group4 group companies filed it, led by Argonaut Insurance Company and Argonaut-Midwest Insurance Company | 19 | 1 | A | Jun 4, 2026 |
| United Fire & CAS GroupUnited Fire and Casualty Company | 15 | 12 | AOriginal | May 4, 2026 |
| AXA Insurance Group5 group companies filed it, led by Greenwich Insurance Company and XL Insurance America, Inc. | 6 | 2 | A | Jun 23, 2026 |
| Acuity, A Mutual Insurance Company | 6 | 2 | A | Jul 1, 2026 |
| Tokio Marine Holdings Incorporated Group2 group companies filed it, led by Safety First Insurance Company and Safety National Casualty Corporation | 6 | 2 | A | May 14, 2025 |
| Donegal Group3 group companies filed it, led by Donegal Mutual Insurance Company and Mountain States Indemnity Company | 5 | 1 | A | Apr 27, 2026 |
| Intact Financial Group3 group companies filed it, led by Atlantic Specialty Insurance Company and OBI America Insurance Company | 5 | 1 | A | Jun 24, 2026 |
| Mutual Capital Group Incorporated GroupIllinois Casualty Company | 5 | 5 | A | Nov 2, 2026 |
| RLI Insurance GroupRLI Insurance Company | 5 | 1 | A | Aug 18, 2026 |
How the largest insurers handle WC 00 03 01
Groups among the largest workers compensation insurers that filed WC 00 03 01 or their own version in the past five years.
- Travelers GroupFiles its own version: XC 99 0012 (00) Alternate Employer Endorsement (39 states)
- Amtrust Financial Services GroupUses WC 00 03 01 in 1 filing
- Zurich Insurance GroupUses WC 00 03 01 in 2 filings
States
Number of filings that include WC 00 03 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 03 02Designated Workplaces Exclusion Endorsement152 filings
- WC 00 03 08Partners, Officers and Others Exclusion Endorsement152 filings
- WC 00 04 06Premium Discount Endorsement152 filings
- WC 00 03 05Joint Venture as Insured Endorsement151 filings
- WC 00 04 03Experience Rating Modification Factor Endorsement150 filings
- WC 00 03 13Waiver of Our Right to Recover From Others Endorsement149 filings
- WC 00 00 00Workers Compensation and Employers Liability Insurance Policy147 filings
- WC 00 03 10Sole Proprietors, Partners, Officers and Others Coverage Endorsement147 filings
- WC 00 04 22Terrorism Risk Insurance Program Reauthorization Act Disclosure Endorsement146 filings
- WC 00 04 21Catastrophe (Other Than Certified Acts of Terrorism) Premium Endorsement145 filings
Recent filings
Latest filings that include this form number. Filed copies open in FilingFocus.
| Submitted | Company | State | Editions | Tracking number |
|---|---|---|---|---|
| Nov 2, 2026 | Illinois Casualty Company | OR | A | ILCC-135079829 |
| Sep 16, 2026 | ZNAT Insurance Company | CT | A | ZICO-135090521 |
| Aug 18, 2026 | RLI Insurance Company | CO | A | RLSC-135057018 |
| Aug 7, 2026 | Motorists Commercial Mutual Insurance Company | WY | A | BSIN-135025946 |
| Jul 1, 2026 | Acuity, A Mutual Insurance Company | CO | A | ACUT-134982793 |
| Jun 30, 2026 | Crestbrook Insurance Companyand 1 more | CO | A | NWPP-135003409 |
| Jun 30, 2026 | National Casualty Company | CO | A | NWPP-135004216 |
| Jun 24, 2026 | Atlantic Specialty Insurance Companyand 2 more | CO | A | BEAC-134978198 |
| Jun 23, 2026 | Allmerica Financial Alliance Insurance Companyand 5 more | CO | A | HNVX-134968029 |
| Jun 23, 2026 | AXA XL Insurance Company Americasand 3 more | CO | A | XLAM-134996276 |
| Jun 15, 2026 | Sompo America Fire and Marine Insurance Companyand 1 more | CO | A | SMPJ-134970923 |
| Jun 12, 2026 | All America Insurance Companyand 1 more | CO | A | CEMC-134982050 |
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