| LCA CASE NUMBER | I-200-21327-722560 |
| STATUS | Certified |
| LCA CASE SUBMIT | 2021-11-23 |
| DECISION DATE | 2021-12-01 |
| 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 | 2022-04-15 |
| END DATE | 2025-04-14 |
| 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 | 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 | 15083686895 |
| 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@fallonhealth.org |
| AGENT REPRESENTING EMPLOYER | True |
| AGENT ATTORNEY LAST NAME | Im |
| AGENT ATTORNEY FIRST NAME | Jang |
| AGENT ATTORNEY MIDDLE NAME | Hyuk |
| AGENT ATTORNEY ADDRESS1 | 1201 Third Avenue, 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 | 14154909051 |
| AGENT ATTORNEY EMAIL ADDRESS | sfo-immigration@fisherphillips.com |
| LAWFIRM NAME BUSINESS NAME | Fisher & Phillips LLP |
| STATE OF HIGHEST COURT | CA |
| NAME OF HIGHEST STATE COURT | California Supreme Court |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | False |
| WORKSITE ADDRESS1 | 10 Chestnut Street |
| LCA CASE WORKLOC1 CITY | Worcester |
| WORKSITE COUNTY | WORCESTER CITY |
| LCA CASE WORKLOC1 STATE | MA |
| WORKSITE POSTAL CODE | 01608 |
| LCA CASE WAGE RATE FROM | 118000 |
| LCA CASE WAGE RATE UNIT | Year |
| PREVAILING WAGE | 117686 |
| PW UNIT OF PAY | Year |
| PW WAGE LEVEL | III |
| PW OES YEAR | 7/1/2021 - 6/30/2022 |
| TOTAL WORKSITE LOCATIONS | 1 |
| AGREE TO LC STATEMENT | True |
| H1B DEPENDENT | False |
| WILLFUL VIOLATOR | False |
| PUBLIC DISCLOSURE | Disclose Business |
| PREPARER LAST NAME | Odell |
| PREPARER FIRST NAME | Mihoko |
| PREPARER MIDDLE INITIAL | K |
| PREPARER BUSINESS NAME | Fisher & Phillips LLP |
| PREPARER EMAIL | modell@fisherphillips.com |
