Today a New York Times story relates how Wal-Mart is upgrading and innovating its health benefit. 

These changes are important to note as they show how pervasive consumer-directed health plans are at very large companies.

Among some of the changes for Wal-Mart employees:

* Access to 2,400 generic medications for $4 a script through its pharmacies (about 1,000 more than under its current retail program and possibly providing insight into a future expansion for all retail customers)

* Health plans with premiums as low as $5 a month (let's see how much cost is a barrier to the 10 percent of Wal-Mart employees who are uninsured)

* Deductibles up to $2,000 (consistent with standard corporate plans)

* 50 ways to customize coverage (consumer choice at its best)

* $100 health care credit (like a HSA)

* Sample plan 1: pay $79 a month, receive a $100 health care credit and have a $500 deductible ($948 a year in premiums)

* Sample plan 2: pay $8 a month, receive a $100 health care credit and have a $2,000 deductible ($96 a year in premiums)

Money quote: "'We are removing any barriers of entry' to the company’s health care plan, Ms. [Linda] Dillman [Executive Vice President of Benefits] said. 'When you are talking about $8 a month and a $100 health care credit, why would you not sign up?'"

Time will tell the impact on Wal-Mart's 125,000 employees estimated to not have health coverage.

But this does give important insight into changes in corporate benefits.

For example, to lower the deductible by $1,500 (to $500 from $2,000), the employee pays $852 in higher premiums - essentially funding 57% of the deductible up front.  Data from the federal 2004 Medical Expenditure Panel Survey shows that 12% of the privately insured used no health care, 41% used less than $500, and 71% used less than $2000 in a given year.

These plans allow employees to buy the coverage they want and, in many cases, suffer the actuarial impact - both positive and negative.