Topic

Health spending accounts

Articles and answers about health spending accounts.

Articles about health spending accounts

Questions about health spending accounts

What expenses can a health spending account (HSA) reimburse?

The same expenses that qualify for the medical expense tax credit, as set by the Canada Revenue Agency, such as prescriptions, dental and vision care, and treatment from licensed practitioners. Your plan’s own rules also apply.

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How does a health spending account work for a business owner or employer?

You set an annual amount for each person, which should be reasonable for their role. When you or an employee has an eligible expense, the claim goes to the plan administrator with the receipt. Once it’s approved, the person is reimbursed tax-free, and your business is billed the claim plus an administration fee and any applicable provincial taxes, as a deductible business expense. An HSA works through an incorporated business: sole proprietors fall under different tax rules, with conditions, so speak with your accountant.

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What happens if HSA funds are not used?

It depends on the carry-forward option you choose when the plan is set up: no carry forward, where unused credits are forfeited; a credit carry forward, where unused credits move to the next year; or an expense carry forward, where this year’s expenses can be claimed next year. Either kind of carry forward is limited to one year.

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Who can be included in a health spending account plan?

Owners, employees and their eligible dependants, in an incorporated business. Each person’s amount should be reasonable for their role, and amounts can differ by employee class, such as management and staff. Sole proprietors fall under different tax rules, with conditions, so speak with your accountant; we set up HSAs for incorporated businesses.

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How is an HSA different from traditional group benefits or a lifestyle spending account?

A traditional group plan is insurance: you pay premiums for set coverage, whether or not it’s used. An HSA reimburses eligible health and dental costs up to the amount you set, and you pay only for the claims that are made. A lifestyle spending account covers lifestyle and wellness costs in the categories you choose, and unlike an HSA, its reimbursements are taxable to the employee. Many employers offer an LSA alongside an HSA or a group plan, rather than on its own.

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How do I choose an HSA provider?

Providers differ in how they check claims: some spot-check them, some don’t check them, and some review every one. We prefer providers that review every claim against the Canada Revenue Agency’s rules, which helps protect the plan’s tax treatment. We’ll also walk you through each provider’s fees, either a percentage of claims or a flat annual fee.

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