March 24, 2025
7 min
What is a Health Spending Account (HSA) and How Does It Work?
A Health Spending Account (HSA) from Hiveworks lets a business reimburse its employees, including owners, for personal medical and dental expenses. These reimbursements are tax-free for the employee and fully deductible for the business. You cover a health expense out of pocket, submit a claim, and the company pays you back.
It is a self-insured plan that turns out-of-pocket costs into business write-offs. Our HSAs are built for small businesses that want flexibility and control.
Who can use it?
To qualify for a Hiveworks HSA, you must meet three requirements: you're an incorporated individual, you're on payroll and receive a T4 from your corporation, and you have no arm’s length employees. This aligns with CRA guidance on eligibility for Health Spending Accounts.
What types of expenses are covered?
Anything the CRA lists as an eligible medical expense can be reimbursed through an HSA. That includes:
- Dental care, from cleanings to braces
- Prescription medications
- Eye exams, glasses, contact lenses
- Mental health services like therapy or counselling
- Physiotherapy, massage, acupuncture, and chiropractic care
- Fertility treatments and assistive devices
Expenses for your spouse and dependants are also eligible, even if they are not employed by the business. You can also use the HSA to cover what insurance does not or in place of insurance altogether.
What does the process look like?
The HSA process is simple:
- Pay for the expense out of pocket, like you normally would
- Submit a claim through Hiveworks by uploading your receipt and a few details
- Your business sends the funds to Hiveworks
- Hiveworks reimburses you, tax-free
That reimbursement is tax-free, and your business writes it off as an expense.
What makes it CRA-compliant?
Some business owners worry about whether an HSA is too good to be true. But this structure is fully supported by the CRA if it is set up correctly.
The CRA classifies HSAs as a Private Health Services Plan (PHSP). To meet the requirements:
- Your business is incorporated
- You are an employee of the business demonstrated by paying yourself a T4 salary
- You have no arm's length employees
- There is a HSA plan in writing
- Expenses occur after the plan is effective
- The reimbursement must be for eligible expenses
When you use a provider like Hiveworks, the structure, documentation, and process are all handled. We support you in staying compliant.
When does an HSA make sense?
An HSA is ideal if:
- You are paying out of pocket for medical or dental costs
- You want a benefit plan with no monthly premiums
- You value flexibility in how and where you spend
- You want a clean way to reduce tax on health spending
Most incorporated individuals just pay for health expenses personally, using their after-tax salary. With an HSA, your business covers the cost instead. You get reimbursed tax-free, and the company gets the write-off.
What makes Hiveworks different?
Hiveworks is built specifically for Canadian small businesses. It's quick to set up, easy to manage, and fully aligned with CRA guidelines. Our platform is modern, automated, and transparent. There are no contracts or hidden fees.
Hiveworks helps you keep more of your money by turning medical expenses into business reimbursements.