| LCA CASE NUMBER | I-200-20069-390749 |
| STATUS | Certified - Withdrawn |
| LCA CASE SUBMIT | 2020-03-09 |
| DECISION DATE | 2021-02-04 |
| ORIGINAL CERT DATE | 2020-03-16 |
| VISA CLASS | H-1B |
| LCA CASE JOB TITLE | Software Development Engineer III |
| SOC CODE | 15-1133.00 |
| SOC TITLE | Software Developers, Systems Software |
| FULL TIME POSITION | True |
| LCA CASE EMPLOYMENT START DATE | 2020-09-08 |
| END DATE | 2023-09-07 |
| TOTAL WORKER POSITIONS | 1 |
| NEW EMPLOYMENT | 0 |
| CONTINUED EMPLOYMENT | 0 |
| CHANGE PREVIOUS EMPLOYMENT | 1 |
| NEW CONCURRENT EMPLOYMENT | 0 |
| CHANGE EMPLOYER | 0 |
| AMENDED PETITION | 0 |
| LCA CASE EMPLOYER NAME | PREMERA BLUE CROSS |
| EMPLOYER ADDRESS1 | 7001 220TH STREET SW |
| EMPLOYER CITY | MOUNTLAKE TERRACE |
| EMPLOYER STATE | WA |
| EMPLOYER POSTAL CODE | 98043 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PHONE | 14259184000 |
| NAICS CODE | 52411 |
| EMPLOYER POC LAST NAME | BROOKMAN |
| EMPLOYER POC FIRST NAME | JANELLE |
| EMPLOYER POC JOB TITLE | HR COMPLIANCE CONSULTANT |
| EMPLOYER POC ADDRESS 1 | 7001 220TH STREET SW |
| EMPLOYER POC CITY | MOUNTLAKE TERRACE |
| EMPLOYER POC STATE | WA |
| EMPLOYER POC POSTAL CODE | 98043 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | 14259183363 |
| EMPLOYER POC EMAIL | JANELLE.BROOKMAN@PREMERA.COM |
| AGENT REPRESENTING EMPLOYER | True |
| AGENT ATTORNEY LAST NAME | Mehta |
| AGENT ATTORNEY FIRST NAME | Radhika |
| AGENT ATTORNEY ADDRESS1 | 1201 Third Avenue |
| AGENT ATTORNEY ADDRESS2 | Suite 2750 |
| AGENT ATTORNEY CITY | Seattle |
| AGENT ATTORNEY STATE | WA |
| AGENT ATTORNEY POSTAL CODE | 98101 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PHONE | 12066822308 |
| AGENT ATTORNEY EMAIL ADDRESS | sea-immigration@fisherphillips.com |
| LAWFIRM NAME BUSINESS NAME | Fisher & Phillips LLP |
| STATE OF HIGHEST COURT | CA |
| NAME OF HIGHEST STATE COURT | Court of Appeals |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | False |
| WORKSITE ADDRESS1 | 7001 220th Street SW |
| LCA CASE WORKLOC1 CITY | Mountlake Terrace |
| WORKSITE COUNTY | SNOHOMISH |
| LCA CASE WORKLOC1 STATE | WA |
| WORKSITE POSTAL CODE | 98043 |
| LCA CASE WAGE RATE FROM | 123797.19 |
| LCA CASE WAGE RATE UNIT | Year |
| PREVAILING WAGE | 122824 |
| PW UNIT OF PAY | Year |
| PW WAGE LEVEL | III |
| PW OES YEAR | 7/1/2019 - 6/30/2020 |
| TOTAL WORKSITE LOCATIONS | 1 |
| AGREE TO LC STATEMENT | True |
| H1B DEPENDENT | False |
| WILLFUL VIOLATOR | False |
| PUBLIC DISCLOSURE | Disclose Business |
| PREPARER LAST NAME | OEM |
| PREPARER FIRST NAME | CLARA |
| PREPARER MIDDLE INITIAL | C |
| PREPARER BUSINESS NAME | FISHER & PHILLIPS LLP |
| PREPARER EMAIL | COEM@FISHERPHILLIPS.COM |
