| CASE NUMBER | I-200-24211-227783 |
| CASE STATUS | Certified |
| RECEIVED DATE | 7/29/2024 |
| DECISION DATE | 8/5/2024 |
| ORIGINAL CERT DATE | |
| VISA CLASS | H-1B |
| JOB TITLE | Data Analyst Lead |
| SOC CODE | 15-1242.00 |
| SOC TITLE | Database Administrators |
| FULL TIME POSITION | Y |
| BEGIN DATE | 9/13/2024 |
| END DATE | 9/12/2027 |
| TOTAL WORKER POSITIONS | 1 |
| NEW EMPLOYMENT | 0 |
| CONTINUED EMPLOYMENT | 0 |
| CHANGE PREVIOUS EMPLOYMENT | 1 |
| NEW CONCURRENT EMPLOYMENT | 0 |
| CHANGE EMPLOYER | 0 |
| AMENDED PETITION | 0 |
| EMPLOYER NAME | USAble Mutual Insurance Company |
| TRADE NAME DBA | Arkansas Blue Cross Blue Shield |
| EMPLOYER ADDRESS1 | 601 South Gaines St. |
| EMPLOYER ADDRESS2 | |
| EMPLOYER CITY | Little Rock |
| EMPLOYER STATE | AR |
| EMPLOYER POSTAL CODE | 72201 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PROVINCE | |
| EMPLOYER PHONE | +15013018925 |
| EMPLOYER PHONE EXT | |
| NAICS CODE | 524114 |
| EMPLOYER POC LAST NAME | Beasley |
| EMPLOYER POC FIRST NAME | Canny |
| EMPLOYER POC MIDDLE NAME | |
| EMPLOYER POC JOB TITLE | HR Generalist Associate |
| EMPLOYER POC ADDRESS1 | 601 S. Gaines St. |
| EMPLOYER POC ADDRESS2 | 3rd Floor |
| EMPLOYER POC CITY | Little Rock |
| EMPLOYER POC STATE | AR |
| EMPLOYER POC POSTAL CODE | 72201 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PROVINCE | |
| EMPLOYER POC PHONE | +15013018925 |
| EMPLOYER POC PHONE EXT | |
| EMPLOYER POC EMAIL | immigration@arkbluecross.com |
| AGENT REPRESENTING EMPLOYER | Yes |
| AGENT ATTORNEY LAST NAME | Samaratunga |
| AGENT ATTORNEY FIRST NAME | Piyumi |
| AGENT ATTORNEY MIDDLE NAME | |
| AGENT ATTORNEY ADDRESS1 | 225 South 6th Street |
| AGENT ATTORNEY ADDRESS2 | Suite 1830 |
| AGENT ATTORNEY CITY | Minneapolis |
| AGENT ATTORNEY STATE | MN |
| AGENT ATTORNEY POSTAL CODE | 55402 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PROVINCE | |
| AGENT ATTORNEY PHONE | +16123516804 |
| AGENT ATTORNEY PHONE EXT | |
| AGENT ATTORNEY EMAIL ADDRESS | psamaratunga@constangy.com |
| LAWFIRM NAME BUSINESS NAME | Constangy, Brooks, Smith & Prophete LLP |
| STATE OF HIGHEST COURT | MN |
| NAME OF HIGHEST STATE COURT | Minnesota Supreme Court |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | No |
| SECONDARY ENTITY BUSINESS NAME | |
| WORKSITE ADDRESS1 | 601 S. Gaines St., |
| WORKSITE ADDRESS2 | |
| WORKSITE CITY | Little Rock |
| WORKSITE COUNTY | PULASKI |
| WORKSITE STATE | AR |
| WORKSITE POSTAL CODE | 72201 |
| WAGE RATE OF PAY FROM | 107,099.00 |
| WAGE RATE OF PAY FROM CLEANED | |
| WAGE RATE OF PAY TO | $110,969.79 |
| WAGE UNIT OF PAY | Year |
| PREVAILING WAGE | $107,099.00 |
| PW UNIT OF PAY | Year |
| PW TRACKING NUMBER | |
| PW WAGE LEVEL | IV |
| PW OES YEAR | 7/1/2024 - 6/30/2025 |
| 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 | Sahai |
| PREPARER FIRST NAME | Manjari |
| PREPARER MIDDLE INITIAL | |
| PREPARER BUSINESS NAME | Constangy, Brooks, Smith, & Prophete, LLP |
| PREPARER EMAIL | msahai@constangy.com |
| BEGIN DATE CONVERTED | 2025-01-09 |
