| LCA CASE NUMBER | I-200-20217-750653 |
| STATUS | Certified |
| LCA CASE SUBMIT | 2020-08-04 |
| DECISION DATE | 2020-08-11 |
| VISA CLASS | H-1B |
| LCA CASE JOB TITLE | System Engineer III |
| SOC CODE | 15-1133.00 |
| SOC TITLE | Software Developers, Systems Software |
| FULL TIME POSITION | Y |
| LCA CASE EMPLOYMENT START DATE | 2021-01-27 |
| END DATE | 2024-01-26 |
| TOTAL WORKER POSITIONS | 1 |
| NEW EMPLOYMENT | 0 |
| CONTINUED EMPLOYMENT | 1 |
| CHANGE PREVIOUS EMPLOYMENT | 0 |
| NEW CONCURRENT EMPLOYMENT | 0 |
| CHANGE EMPLOYER | 0 |
| AMENDED PETITION | 0 |
| LCA CASE EMPLOYER NAME | Blue Cross Blue Shield of Nebraska |
| EMPLOYER ADDRESS1 | 1919 AKSARBEN DRIVE |
| EMPLOYER CITY | OMAHA |
| EMPLOYER STATE | NE |
| EMPLOYER POSTAL CODE | 68180 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PHONE | 14029828661 |
| NAICS CODE | 524298 |
| EMPLOYER POC LAST NAME | Leonard |
| EMPLOYER POC FIRST NAME | Ashley |
| EMPLOYER POC JOB TITLE | Manager, Payroll & HR Administration |
| EMPLOYER POC ADDRESS1 | 1919 AKSARBEN DRIVE |
| EMPLOYER POC CITY | OMAHA |
| EMPLOYER POC STATE | NE |
| EMPLOYER POC POSTAL CODE | 68180 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | 14029828661 |
| EMPLOYER POC EMAIL | ashley.leonard@nebraskablue.com |
| AGENT REPRESENTING EMPLOYER | Y |
| AGENT ATTORNEY LAST NAME | Peck |
| AGENT ATTORNEY FIRST NAME | Amy |
| AGENT ATTORNEY MIDDLE NAME | L |
| AGENT ATTORNEY ADDRESS1 | 10050 Regency Circle |
| AGENT ATTORNEY ADDRESS2 | Suite 400 |
| AGENT ATTORNEY CITY | Omaha |
| AGENT ATTORNEY STATE | NE |
| AGENT ATTORNEY POSTAL CODE | 68114 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PHONE | 14023911991.0 |
| AGENT ATTORNEY EMAIL ADDRESS | amy.peck@jacksonlewis.com |
| LAWFIRM NAME BUSINESS NAME | Jackson Lewis PC |
| STATE OF HIGHEST COURT | NE |
| NAME OF HIGHEST STATE COURT | Supreme Court of Nebraska |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | N |
| WORKSITE ADDRESS1 | 1919 Aksarben Drive |
| LCA CASE WORKLOC1 CITY | Omaha |
| WORKSITE COUNTY | DOUGLAS |
| LCA CASE WORKLOC1 STATE | NE |
| WORKSITE POSTAL CODE | 68180 |
| LCA CASE WAGE RATE FROM | 119026.0 |
| LCA CASE WAGE RATE UNIT | Year |
| PREVAILING WAGE | 107037.0 |
| PW UNIT OF PAY | Year |
| PW WAGE LEVEL | IV |
| PW OES YEAR | 7/1/2020 - 6/30/2021 |
| TOTAL WORKSITE LOCATIONS | 1 |
| AGREE TO LC STATEMENT | Y |
| H-1B DEPENDENT | N |
| WILLFUL VIOLATOR | N |
| PUBLIC DISCLOSURE | Disclose Business |
| PREPARER LAST NAME | Hoffman |
| PREPARER FIRST NAME | Ann |
| PREPARER BUSINESS NAME | Jackson Lewis PC |
| PREPARER EMAIL | ann.hoffman@jacksonlewis.com |
