Recently, North Dakota Insurance Commissioner Adam Hamm submitted the state's Sanford Health Plan to HHS as its benchmark plan recommendation for an essential health benefits (EHB) package. The recommendation comes after the state's request for additional time to allow its legislature to make a final recommendation was denied this summer, and without a final rule from HHS to guide state decisions. In a letter to stakeholders, Commissioner Hamm explained, "The interim Legislative Health Care Reform Review Committee discussed the EHB choice several times, also taking public comment and ultimately indicating their preference for a Sanford Health Plan recommendation."