Coverage description
A National Council on Compensation Insurance (NCCI) standard form. It discloses the federal terrorism backstop under the 2019 reauthorization of the Terrorism Risk Insurance Act: workers compensation covers terrorism losses, the federal government shares losses above a deductible, liability is capped at $100 billion a year, and a premium is charged.
Updated
What the form says
Key clauses from edition C, the latest revision, quoted as filed.
“Your policy provides coverage for workers compensation losses caused by Acts of Terrorism, including workers compensation benefit obligations dictated by state law”
WC 00 04 22 C
Terrorism losses are covered. The endorsement does not exclude terrorism. It confirms that statutory benefits for injuries from an act of terrorism are paid, subject to the policy's other terms.
“except for Pennsylvania, including an act of war, in the case of workers compensation”
WC 00 04 22 C
Act of war counts as an insured loss. For the federal program, workers compensation losses from an act of war are insured losses in every state except Pennsylvania.
“we are not liable for the payment of any portion of the amount of Insured Losses that exceeds $100,000,000,000”
WC 00 04 22 C
The $100 billion annual cap. Once industry insured losses pass $100 billion in a calendar year and the insurer has met its deductible, it pays nothing above the cap and only a pro rata share below it, as the Treasury sets.
“occurring in any calendar year exceed $200,000,000, the United States Government would pay 80% of our”
WC 00 04 22 C · New in this edition
When the federal share applies. When industry insured losses in a year pass $200 million, the federal government reimburses 80% of the insurer's losses above its deductible, which is 20% of its prior year direct earned premium.
How the form has changed
2 changes across 1 revision, newest first. Each edition is compared with the one before it, using wording from filed copies.
Edition C
Compared with edition BLatest editionThe program period follows the 2019 reauthorization: the insurer deductible period runs from January 1, 2021 to December 31, 2027 instead of 2015 to 2020.
Edition B
“beginning on January 1, 2015, and ending on December 31, 2020”
Edition C
“beginning on January 1, 2021, and ending on December 31, 2027”
The federal share is a flat 80% above a $200 million industry trigger, replacing the year-by-year schedule that ran from 85% above $100 million in 2015 to 80% above $200 million in 2020.
Edition B
“would pay 85% of our Insured Losses”
Edition C
“occurring in any calendar year exceed $200,000,000”
Editions
Revision letters as filed, newest first. Filing counts include every state submission that lists the edition.
| Edition | Filings | Companies | States | Filed | Document |
|---|---|---|---|---|---|
| F | 4 | 2 | 1 | Apr 2025 to Apr 2026 | View PDF |
| CLatest | 163 | 98 | 32 | Dec 2021 to Nov 2026 | View PDF |
| B | 17 | 14 | 2 | May 2022 to Jun 2026 | View PDF |
| A | 5 | 5 | 1 | Mar 2022 to Jun 2026 | View PDF |
1 other edition date appears in one or two filings each, often carrier-specific versions: Original.
What the filings show
- Edition in use: in the past 12 months, 47 companies filed edition C and 9 companies filed edition B.
- WC 00 04 21 (Catastrophe (Other Than Certified Acts of Terrorism) Premium Endorsement) is filed alongside it most often, in 174 of the same filings (92%).
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 04 22, out of 46 in total.
| Carrier | Filings | States | Editions, most filed first | Last filed |
|---|---|---|---|---|
| Nationwide Corporation Group11 group companies filed it, led by Crestbrook Insurance Company and Nationwide Agribusiness Insurance Company | 27 | 5 | C | Jun 30, 2026 |
| Brookfield Wealth Solutions Group5 group companies filed it, led by Argonaut Insurance Company and Argonaut-Midwest Insurance Company | 21 | 2 | C | Jun 25, 2026 |
| United Fire & CAS GroupUnited Fire and Casualty Company | 15 | 12 | C | May 4, 2026 |
| AXA Insurance Group5 group companies filed it, led by Greenwich Insurance Company and XL Insurance America, Inc. | 6 | 2 | AC | Jun 23, 2026 |
| Acuity, A Mutual Insurance Company | 6 | 2 | C | 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 | C | May 14, 2025 |
| Donegal Group3 group companies filed it, led by Donegal Mutual Insurance Company and Mountain States Indemnity Company | 5 | 1 | C | Apr 27, 2026 |
| Intact Financial Group3 group companies filed it, led by Atlantic Specialty Insurance Company and OBI America Insurance Company | 5 | 1 | C | Jun 24, 2026 |
| Mutual Capital Group Incorporated GroupIllinois Casualty Company | 5 | 5 | C | Nov 2, 2026 |
| Pinnacol Assurance | 5 | 1 | B | Jun 18, 2026 |
How the largest insurers handle WC 00 04 22
Groups among the largest workers compensation insurers that filed WC 00 04 22 or their own version in the past five years.
- Travelers GroupFiles its own version: XC 99 0027 (00) Terrorism Risk Insurance Program Reauthorization Act Disclosure Endorsement (40 states)
- Amtrust Financial Services GroupFiles its own version: WC 21 0402 C Terrorism Risk Insurance Program Reauthorization Act Disclosure Endorsement (1 state)
- Chubb Limited GroupUses WC 00 04 22 in 2 filings
States
Number of filings that include WC 00 04 22 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 04 21Catastrophe (Other Than Certified Acts of Terrorism) Premium Endorsement174 filings
- WC 00 00 00Workers Compensation and Employers Liability Insurance Policy168 filings
- WC 00 03 08Partners, Officers and Others Exclusion Endorsement164 filings
- WC 00 04 14Notification of Change in Ownership Endorsement159 filings
- WC 00 04 19Premium Due Date Endorsement158 filings
- WC 00 03 11Voluntary Compensation and Employers Liability Coverage Endorsement157 filings
- WC 00 03 13Waiver of Our Right to Recover From Others Endorsement157 filings
- WC 00 03 10Sole Proprietors, Partners, Officers and Others Coverage Endorsement155 filings
- WC 00 04 03Experience Rating Modification Factor Endorsement154 filings
- WC 00 04 06Premium Discount Endorsement151 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 | C | ILCC-135079829 |
| Sep 16, 2026 | ZNAT Insurance Company | CT | C | ZICO-135090521 |
| Aug 18, 2026 | RLI Insurance Company | CO | C | RLSC-135057018 |
| Jul 1, 2026 | Acuity, A Mutual Insurance Company | CO | C | ACUT-134982793 |
| 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 25, 2026 | American National Property And Casualty Company | CO | C | ANPC-134996042 |
| Jun 24, 2026 | Atlantic Specialty Insurance Companyand 2 more | CO | C | 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 | B | PNCA-134982386 |
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 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
- WC 00 03 01 Alternate Employer Endorsement