Coverage description
A National Council on Compensation Insurance (NCCI) standard form. It makes the policy a multiple coordinated policy that covers only the workers you lease from the professional employer organization (PEO) named in the schedule, in the state named there, and no other workers.
Updated
What the form says
Key clauses from edition A, the latest revision, quoted as filed.
“provides coverage for the workers you lease from the professional employer organization (PEO) and in the state listed below”
WC 00 03 23 A · New in this edition
What the policy covers. The policy is written for the client and covers the workers it leases from the scheduled PEO in the scheduled state, on a multiple coordinated policy basis.
“Your policy does not provide coverage for any other workers, leased or non-leased.”
WC 00 03 23 A
What it does not cover. Workers leased from any other source and the client's own direct employees are outside this policy.
“PEO Policy Number”
WC 00 03 23 A · New in this edition
What the schedule records. The schedule lists the PEO, the state where work is performed, any contract or project, and the policy number of the PEO's own policy.
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 editionThe coverage sentence names the PEO and the scheduled state and says coverage is on a multiple coordinated policy basis. The original sentence named only the labor contractor, with the state shown in the schedule.
Original edition
“provides coverage for the workers you lease from the labor contractor listed below”
Edition A
“and in the state listed below on a multiple coordinated policy basis”
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 the original edition and 3 companies filed edition A.
- The newer revision, edition A, first appears Apr 11, 2023 and has been filed by 9 companies in 3 states so far.
- WC 00 03 21 (Labor Contractor Exclusion Endorsement) is filed alongside it most often, in 86 of the same filings (100%).
Filed under
Data from admitted P&C filings with state insurance departments, submitted Nov 2021 to Aug 2026, excluding withdrawn and rejected filings.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 23, out of 19 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 | Original | Jun 4, 2026 |
| AXA Insurance Group5 group companies filed it, led by Greenwich Insurance Company and XL Insurance America, Inc. | 6 | 2 | Original | 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 | Original | May 14, 2025 |
| Intact Financial Group3 group companies filed it, led by Atlantic Specialty Insurance Company and OBI America Insurance Company | 5 | 1 | Original | Jun 24, 2026 |
| RLI Insurance GroupRLI Insurance Company | 5 | 1 | Original | 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 | Original | Jun 15, 2026 |
| State Farm GroupState Farm Fire and Casualty Company | 5 | 1 | Original | 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 | Original | Jun 23, 2026 |
| Arch Insurance Group2 group companies filed it, led by Arch Indemnity Insurance Company and Arch Insurance Company | 4 | 1 | Original | Apr 8, 2026 |
| Louisiana Workers Compensation GroupPrescient National Insurance Company | 4 | 1 | Original | Jul 2, 2025 |
States
Number of filings that include WC 00 03 23 in each state, Nov 2021 to Aug 2026. Darker states have more filings.
Often filed with
Standard-style form numbers that appear in the same filings most often.
- WC 00 03 21Labor Contractor Exclusion Endorsement86 filings
- WC 00 01 06Longshoremen's and Harbor Workers' Compensation Act Coverage Endorsement85 filings
- WC 00 03 05Joint Venture as Insured Endorsement85 filings
- WC 00 03 09Rural Utilities Service Endorsement85 filings
- WC 00 03 22Employee Leasing Client Exclusion Endorsement85 filings
- WC 00 03 11Voluntary Compensation and Employers Liability Coverage Endorsement84 filings
- WC 00 03 13Waiver of Our Right to Recover From Others Endorsement84 filings
- WC 00 03 20Labor Contractor Endorsement84 filings
- WC 00 01 04Federal Employers' Liability Act Coverage Endorsement83 filings
- WC 00 01 08Nonappropriated Fund Instrumentalities Act Coverage Endorsement83 filings
Recent filings
Latest filings that include this form number. Filed copies open in FilingFocus.
| Submitted | Company | State | Editions | Tracking number |
|---|---|---|---|---|
| Aug 18, 2026 | RLI Insurance Company | CO | Original | RLSC-135057018 |
| Jun 30, 2026 | American Casualty Company of Reading, Pennsylvaniaand 5 more | CO | Original | CNAB-135003197 |
| Jun 24, 2026 | Atlantic Specialty Insurance Companyand 2 more | CO | Original | BEAC-134978198 |
| Jun 23, 2026 | Allmerica Financial Alliance Insurance Companyand 5 more | CO | Original | HNVX-134968029 |
| Jun 23, 2026 | AXA XL Insurance Company Americasand 3 more | CO | Original | XLAM-134996276 |
| Jun 15, 2026 | Sompo America Fire and Marine Insurance Companyand 1 more | CO | Original | SMPJ-134970923 |
| Jun 12, 2026 | All America Insurance Companyand 1 more | CO | Original | CEMC-134982050 |
| Jun 4, 2026 | Argonaut-Midwest Insurance Company | CO | Original | ARGN-134974739 |
| Jun 4, 2026 | Argonaut Insurance Company | CO | Original | ARGN-134974742 |
| Jun 4, 2026 | Rockwood Casualty Insurance Company | CO | Original | ARGN-134974764 |
| May 27, 2026 | Alaska National Insurance Company | SC | AOriginal | ALNI-134962436 |
| May 27, 2026 | CopperPoint Casualty Insurance Companyand 1 more | SC | AOriginal | COPP-134964112 |
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