The following endorsements must be attached to every Massachusetts
Assigned Risk Pool policy.
To view the Massachusetts endorsements, click on
the appropriate link.
| WC 00 01 15 |
Notification Endorsement of Pending Law Change to Terrorism Risk Insurance Program Reauthorization Act of 2015 - withdrawn |
| WC 00 04 14 |
Notification of Change in Ownership Endorsement |
| WC 00 04 22 B |
Terrorism Risk Insurance Program Reauthorization Act Disclosure Endorsement - expired December 31, 2020 |
| WC 00 04 22C |
Terrorism Risk Insurance Program Reauthorization Act Disclosure Endorsement - effective January 1, 2021 |
| WC 20 03 01 |
Massachusetts Limits of Liability Endorsement |
| WC 20 03 02 A |
Massachusetts Assessment Charge |
WC 20 03 03 D (pdf)
WC 20 03 03 D (word) |
Massachusetts Notice to Policyholders' Endorsement |
WC 20 03 06 B (pdf)
WC 20 03 06 B (word) |
Massachusetts Limited Other States Benefit Endorsement
|
| WC 20 03 07 |
Massachusetts Assigned Risk Pool Eligibility Endorsement |
| WC 20 04 05 |
Massachusetts Premium Due Date Endorsement |
| WC 20 06 01 A |
Massachusetts Cancellation Endorsement |
| WC 20 06 04 |
Massachusetts Policy Definition Endorsement |