The School District has a self-insured medical employee benefit plan that reimburses participants and beneficiaries for covered medical expenses. Endl suffers from bilateral hydrosalpinges, a condition that causes infertility. Endl underwent in vitro fertilization in an attempt to become pregnant and submitted a claim to the plan seeking reimbursement of her costs. The plan denied Endl's request for reimbursement on the basis that the plan specifically excluded reimbursement for artificial means to achieve pregnancy, including, but not limited to, in vitro fertilization.