Healthcare costs are the second-largest expense after wages for most employers, but the per-employee number is far from uniform. The sector an employer operates in explains much of the spread. Mercer's 2025 National Survey of Employer-Sponsored Health Plans put the average cost of employer health insurance at $17,496 per employee, up 6.0% in a year, and employers in that survey projected about $18,500 per employee for 2026. The average hides wide gaps driven by workforce age, occupational hazards, and the prevalence of chronic conditions. Brokers, HR leaders, and CFOs who benchmark against their own industry can direct cost-containment work where it will pay.
Three forces explain most of the spread: the health risk of the workforce, the physical demands of the work itself, and how each industry's labor market prices benefits. Sectors with older or more injured workers run higher. Sectors with leaner plans and faster turnover run lower. Exact benchmarks come from the Medical Expenditure Panel Survey Insurance Component (MEPS-IC), which publishes average premiums by industry group, and from Mercer and Aon, which report cost by sector in their annual surveys.
Highest healthcare costs: manufacturing, construction, and transportation
Manufacturing and construction sit at the high end. These sectors employ an older workforce doing physically demanding work, so age-related chronic conditions and on-the-job injuries show up together in the claims file. Back injuries, fractures, and repetitive strain are common in construction and industrial settings, and they drive both medical claims and workers' compensation costs. Hypertension, obesity, and tobacco use are also more prevalent in these workforces, which raises pharmacy and outpatient spending over time. Many manufacturing roles are full-time with long tenure, so employees stay on one plan for years and chronic conditions compound rather than churn away.
Transportation and warehousing, including trucking and logistics, add a different mix: long sedentary hours, shift work that disrupts sleep, and elevated rates of metabolic syndrome. Fleets with older drivers and poor sleep patterns tend to run above the national average, though the exact number depends on the workforce's age mix and plan design.
Mid-range costs: retail, hospitality, and food service
Retail, hospitality, and food service sit at or below the national average despite employing many younger, healthier workers. Two things hold costs down. First, turnover: many workers are part-time or seasonal, do not qualify for benefits, or leave quickly, so fewer employees generate long-term claims on one plan. Second, plan design: employers in these sectors often offer high-deductible health plans with more employee cost-sharing, which lowers the employer's premium but shifts part of the cost to workers. Subsectors with heavy physical demands, such as grocery warehousing, can run hotter, so the sector average is not the whole story.
Professional services and tech: rich benefits, younger workforce
Professional services, technology, and finance do not post the lowest premiums, despite having young and healthy workforces. KFF's 2025 survey found that firms where at least 35% of workers earn $80,000 or more had higher average premiums than firms with fewer high-wage workers, for both single coverage ($9,600 versus $9,133) and family coverage. High-wage industries compete for talent with richer benefits, which pushes employer cost up even when the workforce is healthy.
Where these sectors can save is on claims. A younger workforce with lower rates of smoking and obesity files fewer large claims, and many large tech and finance employers self-insure and manage their plans with data analytics and on-site clinics. A startup with a small, young team can still see unpredictable spikes, but mature firms in these sectors often post favorable claims trends. Premium cost and health risk are different numbers. A firm can have rich benefits and low risk, or lean benefits and high risk, and the total bill reflects the combination.
Age, geography, and plan design drive the spread
Age is the biggest single driver of individual spending. CMS data shows per-person personal health care spending for Americans 65 and older reached $22,356 in 2020, nearly 2.5 times the $9,154 spent per working-age adult. Industries with older median workforces, utilities and transportation among them, run higher per-head costs before hazards even enter the picture.
Where the workforce lives matters too. In 2020, per-capita personal health care spending in New England and the Mideast ran 25% and 23% above the national average, according to CMS. A plant in one region can face very different provider prices than an identical plant in another, so industry data must be adjusted for geography before it is useful.
Plan design and contribution strategy do the rest. Industries with strong unions or a tradition of rich benefits, such as energy and mining, tend to carry lower deductibles and copays, so the employer absorbs more of the bill. That makes the employer's premium look higher even when the underlying health risk matches a sector with slimmer plans.
What high-cost employers can do
Employers in manufacturing, construction, and transportation have options that target their specific cost drivers.
- On-site or near-site clinics. Moving primary care and physical therapy closer to the worker reduces claims in high-injury industries by catching problems before they become surgeries.
- Disease management over blanket wellness. RAND's review of workplace wellness programs found an overall return of $1.50 per dollar invested, but the return splits sharply: $3.80 per dollar for disease management and $0.50 per dollar for lifestyle programs. Programs aimed at employees who already have a chronic condition beat generic lifestyle perks.
- Virtual physical therapy. Claims analyses of commercial data found lower total and musculoskeletal-related costs for patients using virtual physical therapy compared with in-person PT. For manual-labor workforces, where musculoskeletal claims are a top cost driver, virtual PT and ergonomic assessment are worth piloting.
- Data-driven targeting. Segment the population by job role and condition, then fund interventions for the cohorts that drive claims rather than spreading one program across everyone.
Industry benchmarking is the starting point. A construction firm will almost always spend more per employee than a software company, but two firms in the same sector can post very different numbers. The ones that outperform their peers know the risk patterns inside their own workforce and build benefits that answer those patterns directly.
Prevention-first benefit design changes the trajectory
Cost variation by industry is real, but the response does not have to be another round of deductibles and cost-shifting. A prevention-first benefit design goes after the drivers that make manufacturing, construction, and transportation expensive in the first place.
WellthCare™ runs alongside an employer's existing ACA-compliant health coverage and is used first. Employees earn reward dollars at the WellthCare Store™ for verified preventive actions, build automatic retirement contributions, and receive $0-co-pay care. For the employer, the effect compounds: more care is handled before it reaches the primary plan, so claims fall, while the reward structure keeps employees engaged in screenings and follow-ups they would otherwise skip. After six to twelve months of real usage, the WellthCare Readiness Index™ shows the employer, in its own data, when and how much it would save by expanding.
The program is structured within established federal frameworks, and every plan of care is reviewed by a nurse practitioner and physician. This article is for general information only and is not legal, tax, or medical advice. Employers should consult their own advisors. See what a WellthCare Plan would look like for your team.