| CASE NUMBER | I-200-24086-830437 |
| CASE STATUS | Certified |
| RECEIVED DATE | 3/26/2024 |
| DECISION DATE | 4/2/2024 |
| ORIGINAL CERT DATE | |
| VISA CLASS | H-1B |
| JOB TITLE | Cloud and Platform Engineer, Senior |
| SOC CODE | 15-1295.00 |
| SOC TITLE | Software Developers, Non R&D |
| FULL TIME POSITION | Y |
| BEGIN DATE | 5/13/2024 |
| END DATE | 5/12/2027 |
| TOTAL WORKER POSITIONS | 1 |
| NEW EMPLOYMENT | 0 |
| CONTINUED EMPLOYMENT | 0 |
| CHANGE PREVIOUS EMPLOYMENT | 0 |
| NEW CONCURRENT EMPLOYMENT | 0 |
| CHANGE EMPLOYER | 1 |
| AMENDED PETITION | 0 |
| EMPLOYER NAME | Group Health Plan, Inc. |
| TRADE NAME DBA | HealthPartners, Inc. |
| EMPLOYER ADDRESS1 | 8170 33rd Avenue South |
| EMPLOYER ADDRESS2 | |
| EMPLOYER CITY | Bloomington |
| EMPLOYER STATE | MN |
| EMPLOYER POSTAL CODE | 55425 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PROVINCE | |
| EMPLOYER PHONE | 19528835100 |
| EMPLOYER PHONE EXT | |
| NAICS CODE | 621491 |
| EMPLOYER POC LAST NAME | Rathbun |
| EMPLOYER POC FIRST NAME | Ruth |
| EMPLOYER POC MIDDLE NAME | A. |
| EMPLOYER POC JOB TITLE | Legal Services Manager, Sr. Paralegal |
| EMPLOYER POC ADDRESS1 | 8170 33rd Avenue South |
| EMPLOYER POC ADDRESS2 | |
| EMPLOYER POC CITY | Bloomington |
| EMPLOYER POC STATE | MN |
| EMPLOYER POC POSTAL CODE | 55425 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PROVINCE | |
| EMPLOYER POC PHONE | 19528835100 |
| EMPLOYER POC PHONE EXT | |
| EMPLOYER POC EMAIL | ruth.a.rathbun@healthpartners.com |
| AGENT REPRESENTING EMPLOYER | Yes |
| AGENT ATTORNEY LAST NAME | Peterson / Vang |
| AGENT ATTORNEY FIRST NAME | Sarah / Yer |
| AGENT ATTORNEY MIDDLE NAME | K. / C. |
| AGENT ATTORNEY ADDRESS1 | 3033 Excelsior Blvd |
| AGENT ATTORNEY ADDRESS2 | Ste 300 |
| AGENT ATTORNEY CITY | Minneapolis |
| AGENT ATTORNEY STATE | MN |
| AGENT ATTORNEY POSTAL CODE | 55416 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PROVINCE | |
| AGENT ATTORNEY PHONE | 16123518100 |
| AGENT ATTORNEY PHONE EXT | |
| AGENT ATTORNEY EMAIL ADDRESS | mn-filed@fragomen.com |
| LAWFIRM NAME BUSINESS NAME | Fragomen, Del Rey, Bernsen & Loewy, LLP |
| STATE OF HIGHEST COURT | MN |
| NAME OF HIGHEST STATE COURT | Supreme Court |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | No |
| SECONDARY ENTITY BUSINESS NAME | |
| WORKSITE ADDRESS1 | 1220 Kent Drive |
| WORKSITE ADDRESS2 | |
| WORKSITE CITY | Duluth |
| WORKSITE COUNTY | GWINNETT |
| WORKSITE STATE | GA |
| WORKSITE POSTAL CODE | 30097 |
| WAGE RATE OF PAY FROM | 105248 |
| WAGE RATE OF PAY FROM CLEANED | |
| WAGE RATE OF PAY TO | $154,677.00 |
| WAGE UNIT OF PAY | Year |
| PREVAILING WAGE | $105,248.00 |
| PW UNIT OF PAY | Year |
| PW TRACKING NUMBER | |
| PW WAGE LEVEL | IV |
| PW OES YEAR | 7/1/2023 - 6/30/2024 |
| PW OTHER SOURCE | |
| PW OTHER YEAR | |
| PW SURVEY PUBLISHER | |
| PW SURVEY NAME | |
| TOTAL WORKSITE LOCATIONS | 2 |
| AGREE TO LC STATEMENT | Yes |
| H 1B DEPENDENT | No |
| WILLFUL VIOLATOR | No |
| SUPPORT H1B | N/A |
| STATUTORY BASIS | |
| APPENDIX A ATTACHED | N/A |
| PUBLIC DISCLOSURE | Disclose Business |
| PREPARER LAST NAME | |
| PREPARER FIRST NAME | |
| PREPARER MIDDLE INITIAL | |
| PREPARER BUSINESS NAME | |
| PREPARER EMAIL | |
| BEGIN DATE CONVERTED | 2025-01-05 |
