| LCA CASE NUMBER | I-200-21271-612063 |
| STATUS | Certified |
| LCA CASE SUBMIT | 2021-09-28 |
| DECISION DATE | 2021-10-05 |
| VISA CLASS | H-1B |
| LCA CASE JOB TITLE | Team Lead, Web Systems Engineering |
| SOC CODE | 15-1132.00 |
| SOC TITLE | Software Developers, Applications |
| FULL TIME POSITION | True |
| LCA CASE EMPLOYMENT START DATE | 2021-10-04 |
| END DATE | 2024-10-03 |
| 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 Mississippi |
| EMPLOYER ADDRESS1 | 3545 Lakeland Drive |
| EMPLOYER CITY | Flowood |
| EMPLOYER STATE | MS |
| EMPLOYER POSTAL CODE | 39232 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PHONE | 16016644984 |
| NAICS CODE | 524114 |
| EMPLOYER POC LAST NAME | Mortimer |
| EMPLOYER POC FIRST NAME | Daniel |
| EMPLOYER POC MIDDLE NAME | E |
| EMPLOYER POC JOB TITLE | Manager, Talent Management |
| EMPLOYER POC ADDRESS1 | 3545 Lakeland Drive |
| EMPLOYER POC CITY | Flowood |
| EMPLOYER POC STATE | MS |
| EMPLOYER POC POSTAL CODE | 39232 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | 16016644984 |
| EMPLOYER POC EMAIL | demortimer@bcbsms.com |
| AGENT REPRESENTING EMPLOYER | True |
| AGENT ATTORNEY LAST NAME | Baggett, IV |
| AGENT ATTORNEY FIRST NAME | D. Earl |
| AGENT ATTORNEY ADDRESS1 | 200 South 10th Street |
| AGENT ATTORNEY ADDRESS2 | Suite 1600 |
| AGENT ATTORNEY CITY | Richmond |
| AGENT ATTORNEY STATE | VA |
| AGENT ATTORNEY POSTAL CODE | 23219 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PHONE | 18044206478 |
| AGENT ATTORNEY EMAIL ADDRESS | chart@williamsmullen.com |
| LAWFIRM NAME BUSINESS NAME | Williams Mullen |
| STATE OF HIGHEST COURT | VA |
| NAME OF HIGHEST STATE COURT | Supreme Court of Virginia |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | False |
| WORKSITE ADDRESS1 | 3545 Lakeland Drive |
| LCA CASE WORKLOC1 CITY | Flowood |
| WORKSITE COUNTY | RANKIN |
| LCA CASE WORKLOC1 STATE | MS |
| WORKSITE POSTAL CODE | 39232 |
| LCA CASE WAGE RATE FROM | 105560 |
| LCA CASE WAGE RATE TO | 135000 |
| LCA CASE WAGE RATE UNIT | Year |
| PREVAILING WAGE | 105560 |
| PW UNIT OF PAY | Year |
| PW WAGE LEVEL | IV |
| PW OES YEAR | 7/1/2021 - 6/30/2022 |
| TOTAL WORKSITE LOCATIONS | 2 |
| AGREE TO LC STATEMENT | True |
| H1B DEPENDENT | False |
| WILLFUL VIOLATOR | False |
| PUBLIC DISCLOSURE | Disclose Business |
| PREPARER LAST NAME | Hart |
| PREPARER FIRST NAME | Christina |
| PREPARER MIDDLE INITIAL | M |
| PREPARER BUSINESS NAME | Williams Mullen |
| PREPARER EMAIL | chart@williamsmullen.com |
