| LCA CASE NUMBER | I-200-24312-460905 |
| STATUS | Certified |
| LCA CASE SUBMIT | 2024-11-07 |
| DECISION DATE | 2024-11-15 |
| VISA CLASS | H-1B |
| LCA CASE JOB TITLE | IT Service Manager IV |
| SOC CODE | 13-1082 |
| SOC TITLE | Project Management Specialists |
| FULL TIME POSITION | True |
| LCA CASE EMPLOYMENT START DATE | 2025-05-09 |
| END DATE | 2028-05-08 |
| 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 | PREMERA BLUE CROSS |
| EMPLOYER ADDRESS1 | 7001 220TH ST SW |
| EMPLOYER CITY | MOUNTLAKE TERRACE |
| EMPLOYER STATE | WA |
| EMPLOYER POSTAL CODE | 98043 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PHONE | 14259184000 |
| EMPLOYER FEIN | 91-0499247 |
| NAICS CODE | 524114 |
| EMPLOYER POC LAST NAME | Brookman |
| EMPLOYER POC FIRST NAME | Janelle |
| EMPLOYER POC JOB TITLE | HR Compliance Partner |
| EMPLOYER POC ADDRESS1 | 7001 220th Street SW |
| EMPLOYER POC ADDRESS2 | Bldg. Palouse, MS 314 |
| EMPLOYER POC CITY | Mountlake Terrace |
| EMPLOYER POC STATE | WA |
| EMPLOYER POC POSTAL CODE | 98043 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | 14259184000 |
| EMPLOYER POC EMAIL | janelle.brookman@premera.com |
| AGENT REPRESENTING EMPLOYER | True |
| AGENT ATTORNEY LAST NAME | Mehta |
| AGENT ATTORNEY FIRST NAME | Radhika |
| AGENT ATTORNEY ADDRESS1 | 1700 7th Ave |
| AGENT ATTORNEY ADDRESS2 | Suite 2200 |
| AGENT ATTORNEY CITY | Seattle |
| AGENT ATTORNEY STATE | WA |
| AGENT ATTORNEY POSTAL CODE | 98101 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PHONE | 12066822308 |
| AGENT ATTORNEY EMAIL ADDRESS | SF-SEA-IMMIFilings@fisherphillips.com |
| LAWFIRM NAME BUSINESS NAME | Fisher & Phillips LLP |
| STATE OF HIGHEST COURT | CA |
| NAME OF HIGHEST STATE COURT | Court of Appeals |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | False |
| WORKSITE ADDRESS1 | 7001 220th St SW |
| LCA CASE WORKLOC1 CITY | Mountlake Terrace |
| WORKSITE COUNTY | SNOHOMISH |
| LCA CASE WORKLOC1 STATE | WA |
| WORKSITE POSTAL CODE | 98043 |
| LCA CASE WAGE RATE FROM | 164944.35 |
| LCA CASE WAGE RATE UNIT | Year |
| PREVAILING WAGE | 146994 |
| PW UNIT OF PAY | Year |
| PW WAGE LEVEL | IV |
| PW OES YEAR | 7/1/2024 - 6/30/2025 |
| TOTAL WORKSITE LOCATIONS | 2 |
| AGREE TO LC STATEMENT | True |
| H 1B DEPENDENT | False |
| WILLFUL VIOLATOR | False |
| PUBLIC DISCLOSURE | Disclose Business |
| PREPARER LAST NAME | Gibbons-Serna |
| PREPARER FIRST NAME | Allison |
| PREPARER MIDDLE INITIAL | R |
| PREPARER BUSINESS NAME | Fisher & Phillips LLP |
| PREPARER EMAIL | agibbonsserna@fisherphillips.com |