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At the start of trading Wednesday, the Nasdaq Composite and the PowerShares QQQ (NASDAQ:QQQ) were each up about 3.5% year-to-date.

Encouraging the bulls is the fact that neither the composite nor QQQ are anywhere close to their all-time highs. QQQ, the fourth-largest U.S. ETF by assets, is flirting with $91, but its all-time closing high is close to $118. On either a nominal or inflation-adjusted basis, the Nasdaq Composite would still need to rally in significant fashion to reach its all-time highs.

There is a Nasdaq-focused ETF that hit another all-time high, the First Trust NASDAQ-100 Ex-Technology Sector Index Fund (NASDAQ:QQXT). First, let's talk about QQXT does not have. As its name implies, it excludes technology stocks. That is correct. An ETF focused on Nasdaq-listed stocks has jumped 5.5% this year with no help from Apple (NASDAQ:AAPL), Facebook (NASDAQ:FB) or Google (NASDAQ:GOOG).

QQXT also does not have $100 million in assets under management. It had $98.3 million as of Feb. 25. So no matter how QQXT is judged, judging the ETF by its size or lack of exposure to familiar tech darlings has proven foolhardy at best. After all, for the three-year period ending Sept. 30, 2013, the NASDAQ-100 Ex-Tech Sector Index thrashed the NASDAQ 100 and the Dow Jones Industrial Average, according to NASDAQ OMX Global Indexes data.

Living in the here and now, there is an easy explanation for QQXT's out-performance. In large part, it boils down to one sector: Health care and on the Nasdaq, health care often means biotechnology. As of Feb. 25, the NASDAQ-100 Ex-Tech Sector Index had a health care weight of almost 22.6%, or about 830 basis points above the sector's weight in the NASDAQ 100.

Five of QQXT's top-10 holdings are biotech stocks. That is not a bad thing. Not with biotech ETFs being among the funds that are seemingly hitting all-time highs on a daily basis. Only consumer services has a larger sector weight than health care in QQXT and its underlying index.

Although no stock accounts for more than 2.7% of QQXT's weight, the ETF offers another advantage: Fair (by comparison) exposure to Tesla (NASDAQ:TSLA) and Netflix (NASDAQ:NFLX). Those stocks combine for just 1.4% of the NASDAQ 100, but both are top-10 holdings in QQXT, combining for almost 4.6% of the ETF's weight. Tesla is QQXT's largest holding.

First Trust NASDAQ-100 Ex-Technology Sector Index Fund

(click to enlarge)

Tom Lydon's clients own shares of QQQ, Apple, Facebook and Google.

Source: This Nasdaq ETF Hits Another All-Time High