Coverage description
A National Council on Compensation Insurance (NCCI) standard form. It applies a deductible to Part One workers compensation benefits in the scheduled states, with the insurer paying the claim and billing you for the deductible, or guaranteeing your payments where the law has you pay directly.
Updated
What the form says
Key clauses from the original edition, which has not been revised, quoted as filed.
“Part One (Workers Compensation Insurance) applies only to benefits in excess of the deductible amount shown in”
WC 00 06 03
What the deductible applies to. Only workers compensation benefits in the listed states are subject to the deductible; employers liability is not. The schedule can set a combined, medical-only or indemnity-only amount for each state.
“This deductible applies separately to each claim for bodily injury by accident or disease.”
WC 00 06 03
How often the deductible applies. Each claim carries its own deductible. Where state law requires a per accident or per disease basis, one deductible applies to everyone injured in the same accident or by the same disease.
“you must reimburse us within 30 days after we send you notice that payment is due”
WC 00 06 03
Who pays the deductible first. The insurer pays the benefits and bills you for the deductible. If you do not repay, it can cancel the policy and keep unearned premium to cover what it paid.
“We will be your guarantor for those payments.”
WC 00 06 03
When you pay injured workers directly. Where the statute requires or allows the employer to pay the deductible, you pay the injured worker yourself and the insurer stands behind those payments, with the same 30-day repayment and cancellation terms if it has to pay.
How the form has changed
Filed copies carry the original 02-1991 edition, with no revision letter.
Editions
Edition dates as filed, newest first. Filing counts include every state submission that lists the edition.
| Edition | Filings | Companies | States | Filed | Document |
|---|---|---|---|---|---|
| OriginalLatest | 146 | 89 | 17 | Jan 2022 to Sep 2026 | View PDF |
What the filings show
- Edition in use: in the past 12 months, 65 companies filed the original edition.
- WC 00 03 08 (Partners, Officers and Others Exclusion Endorsement) is filed alongside it most often, in 128 of the same filings (88%).
Filed under
Data from admitted P&C filings with state insurance departments, submitted Nov 2021 to Sep 2026, excluding withdrawn and rejected filings.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 06 03, out of 33 in total.
| Carrier | Filings | States | Editions, most filed first | Last filed |
|---|---|---|---|---|
| Brookfield Wealth Solutions Group5 group companies filed it, led by Argonaut Insurance Company and Argonaut-Midwest Insurance Company | 20 | 1 | Original | Jun 25, 2026 |
| Nationwide Corporation Group9 group companies filed it, led by AMCO Insurance Company and National Casualty Company | 16 | 1 | Original | Jun 30, 2026 |
| Midwest Family Group2 group companies filed it, led by Midwest Family Mutual Insurance Company and Midwest Family Advantage Insurance Company | 10 | 6 | Original | Jun 29, 2026 |
| United Fire & CAS GroupUnited Fire and Casualty Company | 8 | 5 | Original | May 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 |
| Acuity, A Mutual Insurance Company | 5 | 1 | Original | Jul 1, 2026 |
| Ascot Insurance US Group4 group companies filed it, led by AmFed Advantage Insurance Company and AmFed Casualty Insurance Company | 5 | 4 | Original | Jun 8, 2026 |
| Donegal Group3 group companies filed it, led by Donegal Mutual Insurance Company and Mountain States Indemnity Company | 5 | 1 | Original | Apr 27, 2026 |
| Intact Financial Group3 group companies filed it, led by Atlantic Specialty Insurance Company and OBI America Insurance Company | 5 | 1 | Original | Jun 24, 2026 |
| Louisiana Workers Compensation GroupPrescient National Insurance Company | 5 | 2 | Original | Jul 2, 2025 |
States
Number of filings that include WC 00 06 03 in each state, Nov 2021 to Sep 2026. Darker states have more filings.
Often filed with
Standard-style form numbers that appear in the same filings most often.
- WC 00 03 08Partners, Officers and Others Exclusion Endorsement128 filings
- WC 00 03 10Sole Proprietors, Partners, Officers and Others Coverage Endorsement128 filings
- WC 00 04 03Experience Rating Modification Factor Endorsement127 filings
- WC 00 04 14Notification of Change in Ownership Endorsement126 filings
- WC 00 04 22Terrorism Risk Insurance Program Reauthorization Act Disclosure Endorsement126 filings
- WC 00 03 13Waiver of Our Right to Recover From Others Endorsement125 filings
- WC 00 04 21Catastrophe (Other Than Certified Acts of Terrorism) Premium Endorsement125 filings
- WC 00 04 04Pending Rate Change Endorsement123 filings
- WC 00 04 12Contingent Experience Rating Modification Factor Endorsement123 filings
- WC 00 04 19Premium Due Date Endorsement123 filings
Recent filings
Latest filings that include this form number. Filed copies open in FilingFocus.
| Submitted | Company | State | Editions | Tracking number |
|---|---|---|---|---|
| Sep 16, 2026 | ZNAT Insurance Company | CT | Original | ZICO-135090521 |
| Aug 18, 2026 | RLI Insurance Company | CO | Original | RLSC-135057018 |
| Jul 1, 2026 | Acuity, A Mutual Insurance Company | CO | Original | ACUT-134982793 |
| Jun 30, 2026 | American Casualty Company of Reading, Pennsylvaniaand 5 more | CO | Original | CNAB-135003197 |
| Jun 30, 2026 | Crestbrook Insurance Companyand 1 more | CO | Original | NWPP-135003409 |
| Jun 30, 2026 | National Casualty Company | CO | Original | NWPP-135004216 |
| Jun 29, 2026 | Midwest Family Advantage Insurance Companyand 1 more | CO | Original | MWFM-134995687 |
| Jun 25, 2026 | American National Property And Casualty Company | CO | Original | ANPC-134996042 |
| 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 |
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