WC & EL / PART FOUR / ALPHABETICAL INDEX OF ENDORSEMENTS

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Endorsement Name History
WC 00 04 14 A 90-Day Reporting Requirement – Notification of Change in Ownership Endorsement
Effective as of 01/01/2019 Issued on 01/01/2000
WC 00 04 01 A Aircraft Premium Endorsement . . . (*Withdrawn)
WC 00 03 01 A Alternate Employer Endorsement
WC 00 04 02 Anniversary Rating Date Endorsement... (*Withdrawn)
Effective as of 05/01/2017 Issued on 01/01/2000
WC 00 04 21 E Catastrophe (Other Than Certified Acts of Terrorism) Premium Endorsement
Effective as of 01/01/2021 Effective as of 01/01/2015 Effective as of 09/01/2008
WC 00 01 01 A Defense Base Act Coverage Endorsement
WC 00 03 02 Designated Workplaces Exclusion Endorsement
WC 00 03 03 C Employers Liability Coverage Endorsement
WC 00 04 03 Experience Rating Modification Factor Endorsement
WC 00 04 25 Experience Rating Modification Factor Revision Endorsement
WC 00 01 04 A Federal Employers' Liability Act Coverage Endorsement
Issued on 04/01/2010 Effective as of 01/01/2005
WC 00 00 01 A Information Page
Effective as of 07/01/2011 Effective as of 09/01/2009 Issued on 09/01/2002
WC 00 00 01 F Information Page Notes
Effective as of 10/01/2022 Effective as of 05/01/2020 Effective as of 05/01/2017 Effective as of 03/01/2015 Effective as of 01/01/2015 Effective as of 07/01/2011 Effective as of 09/01/2009 Issued on 09/01/2002
WC 00 03 04 Insurance Company as Insured Endorsement
WC 00 03 05 Joint Venture as Insured Endorsement
WC 00 01 06 A Longshore and Harbor Workers' Compensation Act Coverage Endorsement
Issued on 07/01/2009 Issued on 01/01/2000
WC 00 02 01 B Maritime Coverage Endorsement
Effective as of 01/01/2015 Issued on 01/01/2000
WC 31 06 12 New York Ambulance and Fire District Liability Exclusion Endorsement for County or Town Policies
WC 31 06 09 A New York Ambulance District Liability Exclusion Endorsement for County or Town Policies
Effective as of 01/01/2000 Issued on 01/01/2000
WC 31 03 15 A New York Benefits Deductible Endorsement
WC 31 04 01 New York Construction Classification Premium Adjustment Factor Endorsement (*Withdrawn)
Issued on 10/01/2025 Issued on 01/01/2000
WC 31 03 23 New York Construction Classification Premium Adjustment Program Explanatory Endorsement
WC 31 03 19 N New York Construction Classification Premium Adjustment Program Explanatory Endorsement (*Withdrawn)
Effective as of 10/01/2025 Effective as of 04/01/2024 Effective as of 10/01/2023 Effective as of 01/31/2022 Effective as of 10/01/2021 Effective as of 05/01/2020 Effective as of 01/01/2018 Effective as of 10/01/2016 Effective as of 10/01/2013 Effective as of 02/01/2011 Effective as of 10/01/2007
WC 31 03 01 A New York Coverage for Elected or Appointed Officers of Municipal Corporations or Other Political Subdivisions Endorsement
Effective as of 05/01/2020 Issued on 01/01/2000
WC 31 03 02 A New York Designated Workplace Cancelation Endorsement and Notice of Partial Cancelation
Effective as of 05/01/2020 Issued on 01/01/2000
WC 31 06 01 A New York Domestic Workers Restricted Endorsement
Issued on 01/01/2000 Issued on 01/01/2000
WC 31 03 03 A New York Excess Medical Coverage Endorsement
Effective as of 05/01/2020 Issued on 01/01/2000
WC 31 06 11 A New York Exclusion For Designated Officers and Employees of Ambulance Districts Endorsement
Effective as of 05/01/2020 Issued on 01/01/2000
WC 31 06 02 New York Exclusion For Designated Officers and Employees of Fire Districts Endorsement
WC 31 03 05 B New York Exclusion of Executive Officer Endorsement
WC 31 03 04 New York Executive Officers Exclusion Endorsement
WC 31 06 03 New York Executive Officers Hold Harmless Endorsement
WC 31 06 04 A New York Fire District Liability Exclusion Endorsement for County or Town Policies
Effective as of 05/01/2020 Issued on 01/01/2000
WC 31 06 17 B New York Foreign Voluntary Compensation and Employers Liability Coverage Endorsement
Effective as of 02/01/2020 Effective as of 10/01/2008
WC 31 03 14 A New York Inclusion of Auxiliary Police Endorsement
WC 31 03 06 A New York Inclusion of Executive Officer Endorsement
WC 31 03 07 New York Liability of Municipalities to Police Officers or Paid Firefighter - Exclusion Endorsement
WC 31 03 08 New York Limit of Liability Endorsement
WC 31 03 10 New York Medical Benefits Reimbursement Endorsement
WC 31 04 07 New York Merit Rating Revision Endorsement
WC 31 03 11 New York Non-Subject Employees Exclusion Endorsement
WC 31 03 12 New York Non-Subject Executive Officers Coverage Endorsement
WC 31 03 22 A New York Optional Client Exclusion Endorsement
Effective as of 05/01/2020 Issued on 01/01/2000
WC 31 03 20 A New York Optional Professional Employer Organization (PEO) Endorsement
Effective as of 05/01/2020 Issued on 01/01/2000
WC 31 03 21 A New York Optional Professional Employer Organization (PEO) Exclusion Endorsement
Effective as of 05/01/2020 Issued on 01/01/2000
WC 31 04 04 B New York Pending Payroll Limitation and Premium Differential Endorsement
Effective as of 05/01/2020 Effective as of 05/01/2017
WC 31 06 16 A New York Preferred Provider Organization Endorsement
WC 31 04 03 A New York Preferred Provider Organization Premium Endorsement
WC 31 03 17 A New York Professional Employer Organization (PEO) Endorsement
Effective as of 05/01/2020 Issued on 01/01/2000
WC 31 03 18 A New York Professional Employer Organization (PEO) Exclusion Endorsement
Effective as of 05/01/2020 Issued on 01/01/2000
WC 31 04 05 A NEW YORK SAFE PATIENT HANDLING ACT PROGRAM EXPLANATORY ENDORSEMENT
Effective as of 05/01/2020 Effective as of 10/01/2017
WC 31 04 06 A New York Safe Patient Handling Act Program Explanatory Endorsement
Effective as of 05/01/2020 Effective as of 10/01/2017
WC 31 03 16 C New York Sole Proprietors, Partners and Members of LLC’s PSLC’s, RLLP’s Exclusion Endorsement
Effective as of 05/01/2020 Effective as of 04/01/2015 Effective as of 02/01/2011 Issued on 01/01/2000
WC 31 03 13 C New York Sole Proprietors, Partners and Members of LLC’s, PSLC’s and RLLP’s Coverage Endorsement
Effective as of 05/01/2020 Issued on 02/01/2011 Issued on 01/01/2000
WC 31 06 13 New York Volunteer Ambulance Workers' Benefit Law - Extension of Employers Liability Insurance Endorsement
WC 31 06 10 A New York Volunteer Ambulance Workers' Benefit Law Group Insurance Endorsement
Effective as of 05/01/2020 Issued on 01/01/2000
WC 31 06 08 A New York Volunteer Ambulance Workers' Premium Discount Endorsement
Effective as of 05/01/2020 Issued on 01/01/2000
WC 31 06 07 A New York Volunteer Firefighters' Benefit Law - Extension of Employers Liability Insurance Endorsement
Effective as of 05/01/2020 Issued on 01/01/2000
WC 31 06 05 A New York Volunteer Firefighters' Benefit Law Group Insurance Endorsement
Effective as of 05/01/2020 Issued on 01/01/2000
WC 31 06 06 A New York Volunteer Firefighters' Premium Discount Endorsement
Effective as of 05/01/2020 Issued on 01/01/2000
WC 31 06 18 A New York Workers Compensation Policyholder Notice of Right to Appeal
Effective as of 05/01/2020 Effective as of 03/01/2015
WC 00 01 08 A Nonappropriated Fund Instrumentalities Act Coverage Endorsement
WC 00 01 14 Notification Endorsement of Pending Law Change to Terrorism Risk Insurance Program Reauthorization Act of 2007
Effective as of 01/01/2015 Effective as of 01/01/2014
WC 00 01 15 Notification Endorsement of Pending Law Change to Terrorism Risk Insurance Program Reauthorization Act of 2015
Effective as of 01/01/2021 Effective as of 01/01/2020
WC 00 01 09 C Outer Continental Shelf Lands Act Coverage Endorsement
Effective as of 01/01/2015 Effective as of 07/01/2011
WC 00 04 04 Pending Rate Change Endorsement
WC 00 04 05 Policy Period Endorsement
WC 00 04 06 Premium Discount Endorsement
WC 00 04 19 Premium Due Date Endorsement
WC 00 04 07 Rate Change Endorsement
WC 00 03 09 B Rural Utilities Service Endorsement
Effective as of 07/01/2006 Issued on 01/01/2000
WC 00 04 22 C Terrorism Risk Insurance Program Reauthorization Act Disclosure Endorsement
Effective as of 01/01/2021 Effective as of 01/01/2015 Effective as of 09/01/2008 Effective as of 01/01/2006
WC 00 03 11 A Voluntary Compensation and Employers Liability Coverage Endorsement
WC 00 02 03 Voluntary Compensation Maritime Coverage Endorsement
WC 31 00 02 B Volunteer Ambulance Workers’ Benefit Law Policy
Effective as of 05/01/2020 Issued on 01/01/2000
WC 31 00 03 B Volunteer Ambulance Workers’ Benefit Policy Information Page
Effective as of 05/01/2020 Effective as of 10/01/2008
WC 31 00 01 B Volunteer Firefighter’s Benefit Policy Information Page
Effective as of 05/01/2020 Issued on 10/01/2008
WC 31 00 00 B Volunteer Firefighters’ Benefit Law Policy
Effective as of 05/01/2020 Issued on 01/01/2000
WC 00 03 13 Waiver of Our Right to Recover from Others Endorsement
WC 00 00 00 C Workers Compensation and Employers Liability Insurance Policy
Effective as of 01/01/2015 Effective as of 07/01/2011