United States Court of Appeals For the Seventh Circuit ____________________ No. 23-3356 ESTATE OF MICHAEL GIFFORD, by its special administrator, SUZANNE GIFFORD, Plaintiff-Appellant,

v. OPERATING ENGINEERS 139 HEALTH BENEFIT FUND, Defendant-Appellee. ____________________

Appeal from the United States District Court for the Eastern District of Wisconsin. No. 2:22-cv-00221 — Lynn Adelman, Judge. ____________________

ARGUED SEPTEMBER 13, 2024 — DECIDED JANUARY 13, 2025 ____________________

Before EASTERBROOK, JACKSON-AKIWUMI, and KOLAR, Cir- cuit Judges. KOLAR, Circuit Judge. This is a tragic case. Michael Gifford was a beneficiary of the Defendant-Appellee’s Health Benefit Fund (the Fund) who passed away after seeking medical treatment. This litigation began after the Fund denied a claim for reimbursement of Gifford’s out-of-network medical ex- penses. Because of the deferential standard of review for 2 No. 23-3356 decisions made by the Fund, we are compelled to affirm the district court’s decision to grant the Fund’s motion for sum- mary judgment and its related discovery motion. I. Background We begin with a description of the health benefit plan gov- erning the scope of Gifford’s medical benefits, then turn to Gifford’s medical treatment in July 2021, and finally describe the administrative appeal arising from the denial of benefits, which preceded this litigation. A. Operating Engineers 139 Health Benefit Fund Michael Gifford was a beneficiary of the Operating Engi- neers 139 Health Benefit Fund, which is a self-insured em- ployee benefit plan (the Plan) established by the International Union of Operating Engineers Local 139 to provide medical benefits to employees and their dependents. The Plan is gov- erned by the Employee Retirement Income Security Act of 1974 (ERISA), 29 U.S.C. § 1001 et seq., and administered by a Board of Trustees. The Board of Trustees is comprised of em- ployee trustees appointed by the union and employer trustees appointed by the employer association (Trustees). The Trus- tees are tasked with determining the benefits provided in ac- cordance with the Plan. The Plan is governed by a Summary Plan Description (SPD), which grants Trustees broad discretion to interpret the Plan and determine eligibility for benefits. 1 The SPD provides:

1 While the parties agree that the Summary Plan Description consti- tutes the ERISA-required plan document, we note that summary docu- ments can communicate information to beneficiaries about an ERISA plan, but “their statements do not themselves constitute the terms of the plan.” No. 23-3356 3

The Trustees or, where Trustee responsibility has been delegated to others, the other persons, will be the sole judges of the standard of proof required in any case and the application and in- terpretation of the Plan. Decisions of the Trus- tees or their delegates are final and binding. The Trustees or their delegates have broad discre- tion to determine eligibility for benefits and to interpret Plan language and their decisions will be accorded judicial deference in any subse- quent action at a court or administrative pro- ceeding. Benefits under this Plan will be paid only when the Trustees decide, or persons dele- gated by the Trustees decide, in their discre- tion, that [a participant] or a beneficiary is en- titled to benefits in accordance with the terms of the Plan. (emphasis in original). The SPD states that benefits “are designed to pro