New Health Spending Account (HSA)
A more flexible way to manage eligible health and dental expenses through your corporation.
The Doctors of BC Cost-Plus Plan will close on December 31, 2026, and will be replaced by a new optional Health Spending Account, administered by myHSA. The HSA opens January 6, 2027, and can reimburse eligible expenses incurred on or after January 1, 2027.
Only Cost-Plus is closing. Your Doctors of BC Health and Dental plan insured through Manulife will continue unchanged.
HSA enrolment for 2027
Open enrolment begins October 1, 2026 and closes January 31, 2027. Participation is not automatic. If you currently use Cost-Plus and want the new HSA for 2027, you must enrol.
After January 31, 2027, you can enrol in the HSA during these times:
- Within six months of your incorporation date.
- Annual Health and Dental Options period between September 1–October 31.
Overview
The HSA is an optional feature of the Doctors of BC Health and Dental plan for incorporated physicians. It allows eligible medical and dental expenses that are not reimbursed by your insured plan to be paid through your corporation in a tax-efficient way, subject to Canada Revenue Agency (CRA) requirements.
The HSA can cover physicians and/or Medical Office Staff and their eligible dependants.
Your HSA can help pay eligible expenses that:
- Are not covered by your insured Health and Dental plan.
- Exceed the maximum payable under your insured plan.
- Are only partially reimbursed under your insured plan.
Doctors of BC HSA advantage
- Choose an annual HSA allocation of up to $25,000, based on your needs.
- No setup fee, annual fee, or monthly premium.
- No pre-funding requirement—you pay only when a claim is submitted.
- A low 5% administration fee, plus GST on the fee, applies to each claim.
- Submit and track claims online or through the myHSA mobile app.
Choosing an annual allocation does not require you to deposit that amount in advance. Your selected allocation is the maximum amount available for eligible HSA claims during the plan year, subject to the plan rules.
HSA expense claims
How it works
Here is an example of how an HSA could help with a $5,000 dental expense:
- Pay for the expense
You pay $5,000 for child orthodontics. - Use your insured plan first
The dental office submits the claim to Manulife. Based on the Enhanced Plan provisions, Manulife reimburses you $2,000, leaving a $3,000 out-of-pocket expense. - Submit the remaining eligible expense to myHSA
You submit an HSA claim for the remaining eligible $3,000, along with the applicable supporting documentation, such as your Manulife Explanation of Benefits. - Your corporation funds the HSA claim
myHSA withdraws $3,157.50 from your corporate bank account: the $3,000 claim, plus the 5% administration fee ($150) and GST on the administration fee ($7.50). - You receive your reimbursement
The approved $3,000 HSA claim is deposited directly into your personal bank account.
Instead of paying the $3,000 expense with personal after-tax income, the HSA turns the total $3,157.50, including the administration fee and GST on the fee, into a private health services plan cost, which can be deducted as a business expense by your corporation.
Illustrative tax example
A doctor earning $165,000 a year would need to earn approximately $5,059 before tax to have $3,000 available after personal income tax to pay the expense. By comparison, the corporation would need to earn approximately $3,157.50 to fund the same expense, as well as the HSA administration fee and GST (on the fee). This represents approximately 38% less pre-tax income required to fund the same expense.
Illustration assumes a 40.7% combined federal and B.C. marginal personal income tax rate. Actual tax treatment and savings will vary based on individual and corporate circumstances.
Doctors of BC does not provide tax advice. HSA eligibility, eligible expenses and tax treatment are subject to CRA requirements. Consult your tax advisor to determine how an HSA may apply to you.
Easy online claims through myHSA
myHSA will administer the new Doctors of BC Health Spending Account. A leading Canadian provider, myHSA supports more than 250,000 accounts across Canada.
Participants can submit and track claims online or through the myHSA mobile app or website, check their available HSA balance and receive approved reimbursements directly to their bank account. Approved claims are typically reimbursed within one to three business days.
Eligible expenses
The HSA can reimburse eligible medical and dental expenses in accordance with CRA requirements, up to your available HSA allocation. CRA maintains a detailed list of eligible medical expenses, including many medical, dental, vision, prescription drug, medical-device, and practitioner expenses. Specific conditions apply to some items.
If an expense may be covered by your insured Doctors of BC Health and Dental plan, submit it there first. The HSA is designed to complement your insured coverage and help with eligible amounts that remain unpaid. Expenses already reimbursed by another plan cannot generally be claimed again.
You can claim a total amount up to the HSA maximum amount you have allocated for the year. You may adjust your allocation for the following year during the Annual Options Period between September 1–October 31.
HSA eligibility
Your business
The business sponsoring the HSA must be incorporated and participate in the Doctors of BC Health and Dental Plan. Since HSA claims are paid through the corporation, the corporation should generate active business income to take advantage of the potential tax benefits. Consult your tax advisor about your circumstances.
Physicians
Participating physicians must be enrolled in at least one Doctors of BC Health or Dental benefit. All physicians enrolled under the Physician Class under your business account must receive the same annual HSA allocation.
Medical Office Staff
You can choose to offer the HSA to eligible Medical Office Staff who are enrolled in at least one benefit under the Doctors of BC Health and Dental plan. If you have multiple staff members, you can establish Employee Classes based on a common, work-related characteristic that is applied consistently to everyone who meets that definition. For the insured health and dental benefits, only one employee class is recognized. For the HSA, different employee classes may be used when the distinction is legitimate and consistently applied.
Once you establish an HSA class, you must offer the HSA allocation you designated for that Class to new employees who meet the Class criteria. You may have an Employee Class that has no HSA benefit and an Employee Class that has an HSA benefit. Your Classes and HSA allocation for the next year can be changed during the Annual Options Period between September 1–October 31.
Dependants
The definition of a dependant under the HSA may be broader than the definition of a dependant under your insured Health and Dental Plan.
A dependant is eligible under an HSA if either of the following applies:
- They are the employee’s spouse by marriage or common law.
- They are related to the employee by blood or adoption and:
- Live in the same primary residence.
- Are financially reliant on the employee.
There is no age limit on dependants if they fit the above criteria.
HSA compared with Cost-Plus
Changes in Canada Revenue Agency requirements have made the Cost Plus Plan more limited over time, leading to the Trustee’s decision to close the plan on December 31, 2026, and offer a new HSA with higher limits, greater flexibility, and a more convenient online claims experience.
| Feature | Cost-Plus (closing) | New HSA |
|---|---|---|
| Plan status | Closes December 31, 2026 | Opens January 6, 2027 for eligible expenses incurred January 1, 2027 or later |
| Annual amount | Limited based on the number of dependants in a plan member’s family | Choose an annual HSA allocation up to $25,000 |
| Setup fee | None | None |
| Administration fee | 7% per claim | 5% per claim, plus 5% GST on the fee |
| Minimum administration fee | $25 per claim | None |
| Maximum administration fee | $250 per claim | None |
| Medical Office Staff Employee Classes | Not available | Different HSA amounts may be established for eligible employee classes |
| Claims experience | Doctors of BC website member area; supporting documentation only required if randomly selected for claims audit | Online and mobile myHSA platform; supporting documentation required for each claim |
How to enrol
Enrolment is not automatic. Existing Cost-Plus participants must actively enrol if they want to participate in the new HSA for 2027.
If you are incorporated and do not enrol by January 31, 2027, your next opportunity to join will be during the Annual Options Period (September 1–October 31, 2027) for the 2028 plan year.
- Review the HSA information and speak with your tax advisor about whether the HSA is appropriate for you.
- Choose the annual HSA allocation for the Eligible Physicians Class and, if applicable, each Eligible Employee Class.
- Submit your HSA enrolment between October 1, 2026 and January 31, 2027.
Important dates
- October 1, 2026: Open enrolment in the new HSA opens.
- December 31, 2026: The Cost-Plus Plan closes. Only eligible expenses incurred on or before this date can be claimed under Cost-Plus.
- January 1, 2027: Eligible expenses for the new HSA can be incurred.
- January 6, 2027: The new HSA opens and participants can begin submitting eligible claims incurred on or after January 1.
- January 31, 2027: The initial open enrolment period for the 2027 HSA closes.
- June 30, 2027: Final date to submit eligible Cost-Plus claims incurred on or before December 31, 2026.