I was hospitalized and by the end of the month I owed $100,000. This amount had to be approved by the President of the company before the benefit paid for my hospital stay. He held up the payment of the bill for a couple weeks until he decided to authorize this. So the President of the company knew I was in a psychiatric hospital due to the explaination of this bill. As you can see, this went beyond keeping the information secret within HRD. So you can see that this can happen with a self-insured company, at least in my case.

PS Despite this he and the Chairman of the Board hired me back to direct the effort to get the company out of a major crisis. They trusted me despite my previous visit to the psych hospital and what this implied.