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NCCI exclusion · workers compensation

WC 00 03 02 Designated Workplaces Exclusion Endorsement

Filings
160
latest Nov 2, 2026
Filing companies
97
36 carrier groups
States
30
Latest edition
Original
View PDFs

Coverage description

A National Council on Compensation Insurance (NCCI) standard form. It removes from the policy all work conducted at or from the workplaces listed in the endorsement.

Updated

What the form says

Key clauses from the original edition, which has not been revised, quoted as filed.

“The policy does not cover work conducted at or from”

WC 00 03 02

What is excluded. The exclusion is set by location: the listed workplaces are entered after this sentence, and work done at them or based out of them is outside the policy. That work has to be insured another way.

“is effective on the date issued unless otherwise stated”

WC 00 03 02

When the exclusion starts. Added during the policy term, the exclusion applies from the date the endorsement is issued unless another date is written in, so it does not reach back to earlier work.

How the form has changed

Filed copies carry the original 4-84 edition, with no revision letter.

Editions

Edition dates as filed, newest first. Filing counts include every state submission that lists the edition.

EditionFilingsCompaniesStatesFiledDocument
OriginalLatest1609730Jan 2022 to Nov 2026View PDF

What the filings show

  • Edition in use: in the past 12 months, 58 companies filed the original edition.
  • WC 00 03 01 (Alternate Employer Endorsement) is filed alongside it most often, in 152 of the same filings (95%).

Filed under

Standard WC 135WC 20Employers Liability WC 5

Data from admitted P&C filings with state insurance departments, submitted Nov 2021 to Nov 2026, excluding withdrawn and rejected filings.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 02, out of 36 in total.

CarrierFilingsStatesEditions, most filed firstLast filed
Brookfield Wealth Solutions Group5 group companies filed it, led by Argonaut Insurance Company and Argonaut-Midwest Insurance Company212OriginalJun 25, 2026
Nationwide Corporation Group9 group companies filed it, led by AMCO Insurance Company and Crestbrook Insurance Company201OriginalJun 30, 2026
United Fire & CAS GroupUnited Fire and Casualty Company1512OriginalMay 4, 2026
AXA Insurance Group5 group companies filed it, led by Greenwich Insurance Company and XL Insurance America, Inc.62OriginalJun 23, 2026
Acuity, A Mutual Insurance Company62OriginalJul 1, 2026
Tokio Marine Holdings Incorporated Group2 group companies filed it, led by Safety First Insurance Company and Safety National Casualty Corporation62OriginalMay 14, 2025
Donegal Group3 group companies filed it, led by Donegal Mutual Insurance Company and Mountain States Indemnity Company51OriginalApr 27, 2026
Intact Financial Group3 group companies filed it, led by Atlantic Specialty Insurance Company and OBI America Insurance Company51OriginalJun 24, 2026
Mutual Capital Group Incorporated GroupIllinois Casualty Company55OriginalNov 2, 2026
RLI Insurance GroupRLI Insurance Company51OriginalAug 18, 2026

View all 36 carrier groups

How the largest insurers handle WC 00 03 02

Groups among the largest workers compensation insurers that filed WC 00 03 02 or their own version in the past five years.

States

Number of filings that include WC 00 03 02 in each state, Nov 2021 to Nov 2026. Darker states have more filings.

Tennessee: 1 filingTN1Alabama: 1 filingAL1Florida: 0 filingsFLGeorgia: 3 filingsGA3Oklahoma: 2 filingsOK2South Carolina: 4 filingsSC4Arkansas: 0 filingsARMissouri: 1 filingMO1Indiana: 1 filingIN1Louisiana: 2 filingsLA2Ohio: 1 filingOH1Wisconsin: 0 filingsWITexas: 0 filingsTXKentucky: 2 filingsKY2Iowa: 0 filingsIAKansas: 1 filingKS1Mississippi: 1 filingMS1North Carolina: 0 filingsNCNebraska: 0 filingsNESouth Dakota: 1 filingSD1Montana: 2 filingsMT2New Hampshire: 0 filingsNHVirginia: 0 filingsVAArizona: 2 filingsAZ2Pennsylvania: 0 filingsPARhode Island: 0 filingsRIMichigan: 2 filingsMI2Alaska: 0 filingsAKDistrict of Columbia: 0 filingsDCIdaho: 1 filingID1Maryland: 0 filingsMDWest Virginia: 0 filingsWVUtah: 2 filingsUT2Wyoming: 6 filingsWY6Delaware: 0 filingsDENew Mexico: 2 filingsNM2Colorado: 109 filingsCO109Connecticut: 2 filingsCT2Maine: 0 filingsMENorth Dakota: 1 filingND1Illinois: 1 filingIL1Minnesota: 1 filingMN1New Jersey: 0 filingsNJNew York: 0 filingsNYMassachusetts: 1 filingMA1Washington: 2 filingsWA2Oregon: 1 filingOR1Vermont: 0 filingsVTCalifornia: 0 filingsCANevada: 1 filingNV1Hawaii: 3 filingsHI3
FewerMore filingsNone

Often filed with

Standard-style form numbers that appear in the same filings most often.

  • WC 00 03 01Alternate Employer Endorsement152 filings
  • WC 00 03 08Partners, Officers and Others Exclusion Endorsement150 filings
  • WC 00 03 10Sole Proprietors, Partners, Officers and Others Coverage Endorsement149 filings
  • WC 00 03 13Waiver of Our Right to Recover From Others Endorsement149 filings
  • WC 00 03 05Joint Venture as Insured Endorsement148 filings
  • WC 00 04 03Experience Rating Modification Factor Endorsement148 filings
  • WC 00 04 06Premium Discount Endorsement147 filings
  • WC 00 04 22Terrorism Risk Insurance Program Reauthorization Act Disclosure Endorsement146 filings
  • WC 00 00 00Workers Compensation and Employers Liability Insurance Policy145 filings
  • WC 00 04 14Notification of Change in Ownership Endorsement145 filings

Recent filings

Latest filings that include this form number. Filed copies open in FilingFocus.

SubmittedCompanyStateEditionsTracking number
Nov 2, 2026Illinois Casualty CompanyOROriginalILCC-135079829
Oct 14, 2026Great American Alliance Insurance Companyand 3 moreMIOriginalGACX-135126133
Sep 16, 2026ZNAT Insurance CompanyCTOriginalZICO-135090521
Aug 18, 2026RLI Insurance CompanyCOOriginalRLSC-135057018
Aug 7, 2026Motorists Commercial Mutual Insurance CompanyWYOriginalBSIN-135025946
Jul 1, 2026Acuity, A Mutual Insurance CompanyCOOriginalACUT-134982793
Jun 30, 2026Crestbrook Insurance Companyand 1 moreCOOriginalNWPP-135003409
Jun 30, 2026National Casualty CompanyCOOriginalNWPP-135004216
Jun 25, 2026American National Property And Casualty CompanyCOOriginalANPC-134996042
Jun 24, 2026Atlantic Specialty Insurance Companyand 2 moreCOOriginalBEAC-134978198
Jun 23, 2026Allmerica Financial Alliance Insurance Companyand 5 moreCOOriginalHNVX-134968029
Jun 23, 2026AXA XL Insurance Company Americasand 3 moreCOOriginalXLAM-134996276

View all 160 filings

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