Health Spending Account Rules in Canada (2025): Employers’ Guide


Health Spending Account Rules in Canada (2025): What Employers Must Know

Whether you’re a corporation or a sole proprietor, understanding Health Spending Account (HSA) — also known as Private Health Services Plan (PHSP) — regulations are essential. Here’s your up-to-date guide.


What Is a Health Spending Account (HSA) / PHSP?

An HSA (PHSP) is a CRA-approved setup allowing employers to reimburse employees for healthcare expenses tax-free. Employers deduct these reimbursements as business expenses.


Who Is Eligible to Offer an HSA?

Business TypeEligible?Notes
Incorporated (with employees)YesOwners and employees receive same tax treatment.
Unincorporated / Sole Proprietor with arm’s-length employeesYesAllowed if there’s a genuine employment relationship.
Unincorporated / Sole Proprietor without arm’s-length employeesNoCRA disallows this, treating benefits as taxable. Government of Canada

Contribution Limits & the “Reasonable Basis” Rule

There is no CRA-defined maximum contribution, but employer contributions must be reasonable. A common guideline—used by many providers, including Coastal HSA—is to keep it under 25% of an employee’s gross annual salary.


Tax Treatment & CRA Compliance

  • Reimbursements under a valid HSA are non-taxable to employees and fully deductible for employers.
  • Ensure your HSA is structured as a genuine PHSP. Failing this may result in taxable benefits.

Eligible vs Ineligible Expenses

HSAs reimburse expenses that qualify under CRA’s medical expense criteria—including dental, paramedical, prescription drugs, and equipment. Cosmetic procedures, over-the-counter items without prescription, and non-medical items are excluded.


Administration Requirements & Provider Use

  • The Plan Admin for the organization must add and remove employees.
  • Expect administrative fees (commonly ~ 8 – 10% of claims), which are also deductible.

2025 Updates at a Glance

  • 2024 survey indicates 40% of Canadian employers now offer HSAs—a 10% increase since 2017. Canadian Payroll Services
  • The HSA limit of 25% of salary guideline remains best-practice, not statutory.
  • Always check CRA’s official site for rule changes post-2025.

Practical Example: Small Business Case Study

Example:

  • Incorporated with two full-time employees
  • Annual allocation: $2,500 per employee
  • Employer funds claims as needed + only 6% admin fee at Coastal HSA
  • Employees submit CRA-eligible expenses; reimbursements are tax-free

Simple, flexible, cost-effective.