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Excess Insurance Certificates should not be submitted as a substitution to the Statement of Specific and Aggregate Excess Insurance Coverage (WC-121), but may be submitted in addition to the WC-121. The WC-121 should be submitted in the name of the approved self-insured entity, and only the approved self-insured entity. Forms submitted in the name of the parent company, where the parent company does not hold self-insurance authority, will not be accepted. Forms listing additional subsidiaries of the parent, where the subsidiaries do not hold self-insurance authority, will not be accepted. Excess policies may only be issued by an insurance carrier admitted by the Department of Insurance to do business in this state with specified policy limits and retention amounts approved by the Division. The insurance carrier shall be AM Best rated A- or better.
