| LCA CASE NUMBER | I-200-20178-683391 |
| STATUS | Certified |
| LCA CASE SUBMIT | 2020-06-26 |
| DECISION DATE | 2020-07-06 |
| VISA CLASS | H-1B |
| LCA CASE JOB TITLE | Physician |
| SOC CODE | 29-1069.00 |
| SOC TITLE | Physicians and Surgeons, All Other |
| FULL TIME POSITION | Y |
| LCA CASE EMPLOYMENT START DATE | 2020-08-01 |
| END DATE | 2023-07-31 |
| TOTAL WORKER POSITIONS | 1 |
| NEW EMPLOYMENT | 1 |
| CONTINUED EMPLOYMENT | 0 |
| CHANGE PREVIOUS EMPLOYMENT | 0 |
| NEW CONCURRENT EMPLOYMENT | 0 |
| CHANGE EMPLOYER | 0 |
| AMENDED PETITION | 0 |
| LCA CASE EMPLOYER NAME | Fallon Community Health Plan, Inc. |
| TRADE NAME DBA | Fallon Health |
| EMPLOYER ADDRESS1 | 10 Chestnut Street |
| EMPLOYER CITY | Worcester |
| EMPLOYER STATE | MA |
| EMPLOYER POSTAL CODE | 01608 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PHONE | 15083689559 |
| NAICS CODE | 524114 |
| EMPLOYER POC LAST NAME | Baraban |
| EMPLOYER POC FIRST NAME | Steve |
| EMPLOYER POC JOB TITLE | Director, Talent Acquisition |
| EMPLOYER POC ADDRESS1 | 10 Chestnut Street |
| EMPLOYER POC CITY | Worcester |
| EMPLOYER POC STATE | MA |
| EMPLOYER POC POSTAL CODE | 01608 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | 15083689559 |
| EMPLOYER POC EMAIL | steve.baraban@fallonhealthy.org |
| AGENT REPRESENTING EMPLOYER | Y |
| AGENT ATTORNEY LAST NAME | Butani |
| AGENT ATTORNEY FIRST NAME | Arit |
| AGENT ATTORNEY ADDRESS1 | 655 Montgomery Street |
| AGENT ATTORNEY ADDRESS2 | Suite 1150 |
| AGENT ATTORNEY CITY | San Francisco |
| AGENT ATTORNEY STATE | CA |
| AGENT ATTORNEY POSTAL CODE | 94111 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PHONE | 14153983500.0 |
| AGENT ATTORNEY EMAIL ADDRESS | abutani@ebglaw.com |
| LAWFIRM NAME BUSINESS NAME | Epstein, Becker & Green, P.C. |
| STATE OF HIGHEST COURT | WA |
| NAME OF HIGHEST STATE COURT | Washington State Supreme Court |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | N |
| WORKSITE ADDRESS1 | 108 Thompson Road |
| LCA CASE WORKLOC1 CITY | Webster |
| WORKSITE COUNTY | WEBSTER |
| LCA CASE WORKLOC1 STATE | MA |
| WORKSITE POSTAL CODE | 01570 |
| LCA CASE WAGE RATE FROM | 194646.0 |
| LCA CASE WAGE RATE TO | 230000.0 |
| LCA CASE WAGE RATE UNIT | Year |
| PREVAILING WAGE | 194646.0 |
| 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 | Y |
| H-1B DEPENDENT | N |
| WILLFUL VIOLATOR | N |
| PUBLIC DISCLOSURE | Disclose Business |
| PREPARER LAST NAME | Calderon |
| PREPARER FIRST NAME | Luisa |
| PREPARER MIDDLE INITIAL | A |
| PREPARER BUSINESS NAME | Epstein, Becker & Green, P.C. |
| PREPARER EMAIL | lcalderon@ebglaw.com |
