| LCA CASE NUMBER | I-200-21225-521456 |
| STATUS | Certified - Withdrawn |
| LCA CASE SUBMIT | 2021-08-13 |
| DECISION DATE | 2021-08-24 |
| ORIGINAL CERT DATE | 2021-08-20 |
| VISA CLASS | H-1B |
| LCA CASE JOB TITLE | APPLICATION DEVELOPER III |
| SOC CODE | 15-1132.00 |
| SOC TITLE | Software Developers, Applications |
| FULL TIME POSITION | True |
| LCA CASE EMPLOYMENT START DATE | 2022-02-11 |
| END DATE | 2025-02-10 |
| 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 MICHIGAN |
| EMPLOYER ADDRESS1 | 600 E LAFAYETTE BLVD |
| EMPLOYER CITY | DETROIT |
| EMPLOYER STATE | MI |
| EMPLOYER POSTAL CODE | 48226 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PHONE | 13132255960 |
| NAICS CODE | 524114 |
| EMPLOYER POC LAST NAME | BUSOVICKI |
| EMPLOYER POC FIRST NAME | MIKE |
| EMPLOYER POC JOB TITLE | MANAGER, TALENT ACQUISITION |
| EMPLOYER POC ADDRESS1 | 600 E LAFAYETTE BLVD |
| EMPLOYER POC CITY | DETROIT |
| EMPLOYER POC STATE | MI |
| EMPLOYER POC POSTAL CODE | 48226 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | 13132255960 |
| EMPLOYER POC EMAIL | MBUSOVICKI@BCBSM.COM |
| AGENT REPRESENTING EMPLOYER | True |
| AGENT ATTORNEY LAST NAME | HERRMANN |
| AGENT ATTORNEY FIRST NAME | CHRISTIAN |
| AGENT ATTORNEY ADDRESS1 | 300 N. MAIN STREET, SUITE 500 |
| AGENT ATTORNEY CITY | GREENVILLE |
| AGENT ATTORNEY STATE | SC |
| AGENT ATTORNEY POSTAL CODE | 29601 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PHONE | 18642408214 |
| AGENT ATTORNEY EMAIL ADDRESS | CHRISTIAN.HERRMANN@OGLETREE.COM |
| LAWFIRM NAME BUSINESS NAME | OGLETREE DEAKINS NASH SMOAK & STEWART PC |
| STATE OF HIGHEST COURT | CA |
| NAME OF HIGHEST STATE COURT | CALIFORNIA SUPREME COURT |
|
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | False |
| WORKSITE ADDRESS1 | 441 E JEFFERSON AVE |
| LCA CASE WORKLOC1 CITY | DETROIT |
| WORKSITE COUNTY | WAYNE |
| LCA CASE WORKLOC1 STATE | MI |
| WORKSITE POSTAL CODE | 48226 |
| LCA CASE WAGE RATE FROM | 104599 |
| LCA CASE WAGE RATE TO | 105004 |
| LCA CASE WAGE RATE UNIT | Year |
| PREVAILING WAGE | 104599 |
| PW UNIT OF PAY | Year |
| PW OTHER SOURCE | Survey |
| PW OTHER YEAR | 2020 |
| PW SURVEY PUBLISHER | MERCER, LLC |
| PW SURVEY NAME | MERCER BENCHMARK DATABASE/TOTAL REMUNERATION SURVEY |
| TOTAL WORKSITE LOCATIONS | 2 |
| AGREE TO LC STATEMENT | True |
| H-1B DEPENDENT | False |
| WILLFUL VIOLATOR | False |
| PUBLIC DISCLOSURE | Disclose Business |
