The Most Common Questions Employees Have About HSAs

Sarah Delorme
Market Insights
April 13, 2025
12 min read

Health Spending Accounts (HSAs) have become a vital part of modern employee benefits programs in Canada. Still, for many employees, HSAs can be confusing—especially when compared to traditional insurance or newer offerings like WSAs. To help employers educate their teams, we’ve compiled answers to the most common questions employees ask about HSAs.

1. What Is an HSA and How Does It Work?

An HSA, or Health Spending Account, is an employer-funded account that reimburses employees for out-of-pocket medical expenses. It’s a tax-effective way to offer flexible healthcare benefits.

Here’s how HSA works:

  • The employer allocates a set amount of money to each employee annually.

  • Employees submit claims for eligible medical expenses.

  • Once approved, they receive a reimbursement—tax-free.

This structure gives employees more control compared to traditional group insurance plans.

2. What Are HSA Eligible Expenses?

Employees often ask what qualifies for reimbursement under an HSA. According to CRA guidelines, HSA eligible expenses include:

  • Prescription medications

  • Dental cleanings and treatments

  • Vision care (exams, glasses, contacts)

  • Physiotherapy and chiropractic

  • Mental health services

For a full list of Health Spending Account Canada eligible expenses, employers should provide CRA-compliant documentation or links to official resources.

3. What’s the Difference Between an HSA and a WSA?

Another frequent question is about the distinction between an HSA and a WSA (Wellness Spending Account).

Here’s the breakdown:

  • HSA: Covers health-related expenses, tax-free to the employee.

  • WSA: Covers wellness and lifestyle expenses, taxable as a benefit.

Common wsa eligible expenses include:

  • Gym memberships

  • Meditation or mindfulness apps

  • Life coaching

  • Personal development workshops

Understanding WSA vs HSA helps employees make smarter decisions about their health and wellness spending.

4. Is an HSA Better Than Traditional Group Insurance?

Employees often compare group insurance vs HSA. The answer depends on individual needs:

  • Group Insurance: Standardized coverage; less flexibility.

  • HSA: More personal choice and control; employees decide how to spend their funds.

Many companies now combine both for a more complete and flexible benefits offering.

5. Do HSAs Offer Tax Benefits?

Yes. One of the biggest advantages of an HSA is the tax benefits of offering health spending. For employees:

  • Reimbursements are not considered taxable income.

For employers:

  • Contributions are a tax-deductible business expense.

This makes HSAs a win-win solution for both parties.

6. Can I Have a WSA and HSA at the Same Time?

Absolutely. Many Canadian companies offer both HSAs and WSAs to meet a wider range of employee needs.

For example:

  • Use your HSA for dental care and prescriptions.

  • Use your WSA to get a wellness spending account benefit like a yoga membership or fitness tracker.

This dual benefit system aligns with trends around the best employee benefits in Canada.

7. Are My Claims Secure and Easy to Submit?

With the help of modern employee benefits software, claims are processed quickly and securely. Most platforms allow employees to:

  • Upload receipts via mobile apps

  • Track balances in real time

  • Receive direct deposit reimbursements

This integration improves overall experience and transparency.

8. How Is This Better Than the Best Health Insurance in Canada?

While some might ask about the best health insurance in Canada, it’s important to clarify that HSAs are not insurance—they are reimbursement accounts.

However, many employees prefer HSAs for the flexibility, transparency, and ease of use compared to traditional insurance. Pairing them with group benefits Canada options creates a comprehensive solution.

9. What Happens If I Don’t Use My Full HSA Amount?

Employers can set rollover rules. Some allow unused funds to carry over to the next year, while others have a “use it or lose it” policy. It’s important for employees to understand their specific plan terms.

10. Where Can I Learn More About My Plan?

Employees should speak with their HR department or review their company’s employee benefits Canada documentation. Helpful details include:

  • Reimbursement limits

  • Eligible and ineligible expenses

  • Submission deadlines

  • Integration with other benefits

Final Thoughts

Helping employees understand their HSA empowers them to make better healthcare and financial decisions. Whether paired with a WSA or traditional group insurance, HSAs are a powerful tool for building a modern, personalized benefits strategy.

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