HSA & PHSP Overview - For Accountants

What is a Health Spending Account?

(PHSP context)

Health Spending Accounts are typically structured to meet the definition of a Private Health Services Plan (PHSP) under CRA guidelines. When properly set up, reimbursements are deductible to the corporation and received tax-free by the employee.

CRA Framework (simplified)

To qualify as a PHSP, a plan must generally:

  • Reimburse expenses eligible under the Medical Expense Tax Credit (METC)

  • Cover primarily medical expenses (generally 90% or more)

  • Operate as a reimbursement plan for actual expenses incurred

  • Be provided to employees and eligible dependants

Based on guidance from the Canada Revenue Agency (CRA) on Private Health Services Plans.

Canada Revenue Agency (CRA)

Common Situations

Typical scenarios:

  • Incorporated business owner receiving T4 income

  • Owner + spouse - commonly structured

  • Small incorporated team - scalable

Not typically suitable:

  • Sole proprietors

  • Dividend-only compensation

  • No employer-employee relationship

Tax Treatment - General Overview

When structured as a PHSP:

  • Reimbursements are generally tax-deductible to the corporation

  • Benefits are typically received tax-free by the employee(s)

  • The plan must reflect a legitimate employer-employee relationship

Practical Considerations:

  • Annual limits should be reasonable relative to compensation

  • HSAs are typically used as a supplement to compensation, not a replacement

  • Plan design should be consistent with what a similar employee might reasonably receive

Important Notes:

  • Eligibility depends on how the business is structured and how individuals are compensated

  • Situations involving dividend-only compensation may not meet CRA expectations

  • Specific tax treatment can vary and should be considered alongside the broader compensation structure

Have a specific situation you’d like to discuss?

I’m happy to review a specific scenario or walk through how this may apply.