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Coverages Available

A. Statutory Workers' Compensation (Part One)

Coverage required under the Massachusetts Workers' Compensation Act (M.G.L. Ch. 152) is provided by the standard policy.

B. Employers Liability (Part Two)

The standard limits of liability (code 9845) are:

Bodily Injury by Accident $100,000 - each accident
Bodily Injury by Disease    $500,000 - policy limit
Bodily Injury by Disease    $100,000 - each employee

The increased limits of liability available in the Pool, which are subject to an additional charge, are as follows: (000 omitted)

($)    100/100/1,000        .50%   with   $75.00 minimum - code 9803
            500/500/500      1.00%   with   $50.00 minimum - code 9807
         500/500/1,000      1.25%   with   $75.00 minimum - code 9808
   1,000/1,000/1,000      2.00%   with   $75.00 minimum - code 9812

C. Other States Insurance (Part Three)

Other states coverage is available ONLY on a limited basis. Refer to Massachusetts Limited Other States Benefit Endorsement, WC 20 03 06B. Carriers must insert "Massachusetts" (or "MA") and only "Massachusetts" (or "MA"), in Item 3A of the Information Page on all Pool policies, and carriers must insert "COVERAGE REPLACED BY ENDORSEMENT WC 20 03 06 B" in Item 3C. Refer to Special Bulletin No. 06-13 for additional information about this endorsement.

D. Optional Coverages / Endorsements

NAME ENDORSEMENT # CONDITIONS OF AVAILABILITY PREMIUM CHARGE
Alternate Employer WC 00 03 01 A Available if required by contract. None
Defense Base Act WC 00 01 01 A Available upon request and if exposure exists. Extension of USL&H. Same premium charge.
Designated Workplaces Exclusion WC 00 03 02 Available upon request and if application is allowable under M.G.L. Ch. 152. None
Domestic and Agricultural Workers Exclusion WC 00 03 15 Available, but only to exclude part time domestic servants as defined by M.G.L. Ch. 152. None
Longshore & Harbor Workers Act WC 00 01 06 A Available in conjunction with State Act Coverage, upon request and if exposure exists.
Available 7/1/2016 –
when used in conjunction with Program II – USL&H Act Benefits for admiralty law.
Eligible Non-F class rates are increased by USL&H compensation coverage % on MA Rates - Miscellaneous Values page.
Maritime -
(Program I and II)
WC 00 02 01 B To be used in conjunction with State Act Coverage to provide employers liability protection under Program I or Program II for admiralty law.* Refer to Part I of the MA Manual. If Transportation, Wage, Maintenance and Cure Coverage is required by contract, it can be provided at no fee by addition $0 in Item 2 of the Schedule.
Massachusetts Benefits Deductible Endorsement WC 20 06 02 Available. Insured must request the deductible program before the effective date of the policy, otherwise before the next renewal of the policy. Apply the appropriate premium reduction percentage to the policy's standard premium. Refer to the Miscellaneous Values page of the MA Manual.
Massachusetts Benefits Claim and Aggregate Deductible Endorsement WC 20 06 03 A Available. Insured must request the deductible program before the effective date of the policy, otherwise before the next renewal of the policy. Apply the appropriate premium reduction percentage to the policy's standard premium. Refer to the Miscellaneous Values page of the MA Manual.
Non-appropriated Fund Instrumentalities Act WC 00 01 08 A Available upon request and if exposure exists. Extension of USL &H. Same premium charge.
Outer Continental Shelf Lands Act WC 00 01 09 C Available upon request and if exposure exists. Extension of USL &H. Same premium charge.
Partners, Officers and Other Exclusion Endorsement WC 00 03 08 Available. To be used to identify corporate officers or directors who own at least 25% of the issued and outstanding stock of a corporation and who have been approved to exclude themselves from coverage in accordance with M.G.L. Chapter 152, Section 1(4) and MA DIA Regulation 452 CMR 8.06. None
Sole Proprietors, Partners, Officers and Others Coverage Endorsement WC 00 03 10 Available. To be used to identify sole proprietors, partners, or members of an LLC who have elected to obtain coverage for themselves as employees in accordance with M.G.L. Chapter 152, Section 1(4) and MA DIA Regulation 452 CMR 8.07. The premium basis for each sole proprietor, partner, or member of an LLC shall be based on a fixed amount equal to the State Average Weekly Wage x 52. Refer to the Miscellaneous Values page of the MA Manual for the Basis of Premium.
Voluntary Compensation Maritme Coverage Endorsement (Program II) WC 00 02 03 To be used in conjunction with State Act Coverage to provide employers liability protection under Program II and with WC 00 02 01 B for admiralty law.* Refer to Part I of the MA Manual.
Waiver of Our Right to Recover From Others WC 00 03 13 Available if required by contract. 2% of developed premium for the specific job for which the endorsement is required.

* Effective 7/01/2016 - the standard limits of liability for admiralty are:

$10,000 - all bodily injury arising out of any one accident.

Increased limits of liability for admiralty insurance of $50,000 per occurrence or a maximum of $100,000 per occurrence are available.

Resources

Assigned Risk Pool Plan of Operation

Coverages Available

Depopulation Reports

MA Take-Out Credit Program

Pool Data

Residual Market Load Estimator

Servicing Carriers

VDAC Carriers

Voluntary Direct Assignment (VDAC) Program

The Workers' Compensation Rating and Inspection Bureau of Massachusetts
101 Arch Street, 5th Floor
Boston, MA 02110