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Health Spending Accounts (HSAs) are a Smart Move for Small Businesses

18 September 2026
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    a 30-something man with a beard, baseball hat, and work apron sits at a table looking at a laptop and talking to a woman sitting next to him. A woman, also in a work apron, stands behind them also looking at the laptop and engaged in the conversation

    As a small business owner it can be a balancing act to keep good employees happy while managing costs. Understanding employee benefits and choosing the right ones to meet needs and budget can be tough. Take a look at Health Spending Accounts (HSAs). They can change the game for small businesses.

    Nowadays, traditional health insurance isn’t the only option out there. HSAs are a smart and customizable alternative that both employers and employees can capitalize on. Adding an HSA in your benefits package could be a savvy move.

    What is a Health Spending Account (HSA)?

    • The employer sets customized spending limits for different types of employees. For instance, a manager might have a higher spending limit than full-time staff.
    • Each month, the employer puts a fixed amount of money into the HSA.
    • When employees incur a health care expense, they pay for them upfront.
    • After covering the health care costs, employees file a claim to be reimbursed from the HSA. They get back 100% of the money tax-free.
    • Employers pay for the expense plus an 8% administration fee. But, both the cost of the health care and the admin fee are tax-deductible for the employer.
    • If employees don’t use all the money in the HSA, the funds are returned to the business, so there is no waste.

    Benefits of HSAs for employers: saving money and tailored plans

    HSAs help businesses keep costs in check. Unlike conventional health insurance, HSAs don’t have fixed premiums. So as a small business, you can handle your finances better while still offering excellent benefits. You can tailor HSA plans to suit your company’s specific needs and budget. And, setting up and managing HSAs is relatively simple.

    Benefits of HSAs for employees: tax-free healthcare

    Health Spending Accounts also benefit employees. One major perk is that contributions to HSAs are tax-free. This allocates more money to employees to pay for medical treatments and services. The other benefit is that, because an HSA is a pool of money, employees can choose the treatments and services. There aren’t specific categories and limits, such as $500 for physio, or $400 for orthotics.

    Health Spending Account FAQs

    Here are some of the most common questions people ask our advisors.

    Who qualifies for an HSA?

    Most incorporated small businesses, consultants, and professionals will qualify for a Health Spending Account. If you’re a sole proprietor, you only qualify for an HSA if you have at least one employee who isn’t a relative.

    How much can I contribute to an HSA?

    With an HSA, you set the annual spending limit. The CRA doesn’t specify any limits. However, the amount must be reasonable for your business’s size and structure. If you have employees, you can set different limits. Managers may have a higher allowance than staff, for example. HSAs are a viable alternative to a group benefits plan, as there is more control over costs.

    What health care expenses can be covered with an HSA?

    HSAs cover many of the same types of health care expenses that covered by standard health insurance policies. Things like:

    • Dental care
    • Prescription drugs
    • Vision care
    • Paramedical services like physiotherapy, chiropractic, and massage
    • Mental health care
    • Medical devices

    As with all policies, check the details. And if there is care that you need, be sure to ask about it specifically.

    Can I include my spouse or dependents in HSA coverage?

    Yes, most Health Spending Accounts allow you to include your spouse and dependents. CRA states that everyone needs to be named in the policy, but they all draw from the same spending pool.

    Is an HSA the same as a PHSP?

    PHSP stands for Private Health Services Plan. An HSA is a type of PHSP. HSAs must be structured as a PHSP and follow CRA’s rules for eligibility and plan design. HSA is a modern, flexible version of a PHSP.

    Are health spending accounts right for your business?

    As you can see, the value of HSA benefits goes straight from the business to its employees. The complexity of insurance premiums and deductibles is side-stepped. Employees have flexibility and coverage. Employers maximize value because they are cost-effective, and have great tax benefits. And it makes your business more attractive to potential employees.

    Want to discover how you can save money, empower employees, and take charge of health care benefits for your business? Reach out to one of our insurance advisors.

    author avatar
    Dan MacLellanPresident
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