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Workers Compensation and Employers Liability

24 forms available for WC

Coverage (1 forms)

Form Code Title Latest Edition States
WC 00 00 00Workers Compensation and Employers Liability Insurance Policy (Policy Form) 04 16 All States

Endorsement (21 forms)

Form Code Title Latest Edition States
WC 00 01Federal Coverage Endorsements (Series) N/A All States
WC 00 01 01Defense Base Act Coverage Endorsement A All States
WC 00 01 02Federal Coal Mine Health and Safety Act Coverage Endorsement 01 15 All States
WC 00 01 04Federal Employers' Liability Act Coverage Endorsement 04-1984 All States
WC 00 01 06Longshore and Harbor Workers' Compensation Act Coverage Endorsement 04-92 All States
WC 00 01 08Nonappropriated Fund Instrumentalities Act Coverage Endorsement A All States
WC 00 01 09Outer Continental Shelf Lands Act Coverage Endorsement 07 11 All States
WC 00 02Maritime Coverage Endorsement 11-95 All States
WC 00 02 03Voluntary Compensation Maritime Coverage Endorsement 04-84 All States
WC 00 02 04Limited Maritime Coverage Endorsement 06 92 All States
WC 00 03Workers Compensation General Endorsements (NCCI Series 03) N/A All States
WC 00 03 00Alternate Employer Endorsement 01 03 All States
WC 00 03 02Waiver Of Our Right To Recover From Others Endorsement 04 84 All States
WC 00 03 08Maritime Coverage Endorsement 04 84 All States
WC 00 03 10Longshore And Harbor Workers' Compensation Act Coverage Endorsement 04 84 All States
WC 00 04Pending Rate Change Endorsement 04 84 All States
WC 00 04 22Terrorism Risk Insurance Program Reauthorization Act Disclosure Endorsement 09-08 MA, NY, PA, MI, CA, DE, NC
WC 20 01Massachusetts Terrorism Risk Insurance Program Reauthorization Act Endorsement 01 08 MA
WC 20 01 01Massachusetts - Benefits And Contract Endorsement 01 01 MA
WC 31 03New York Limit of Liability Endorsement 04 84 NY
WC 31 03 01New York - Construction Classification Premium Adjustment Program Endorsement 01 97 NY

Exclusion (1 forms)

Form Code Title Latest Edition States
WC 00 03 13Partners, Officers And Others Exclusion Endorsement 04 84 All States

Other (1 forms)

Form Code Title Latest Edition States
WC 00 00 01Workers Compensation and Employers Liability Insurance Policy Information Page 01 17 All States