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Canada Health Spending Accounts

Your On-Line Source for Canadian Health Spending Accounts

Call Us Free: 1.800.880.6806

Enroll

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Thank you for starting your application for a CHSA Health Spending Account. A CHSA representative will be contacting you to finalize and verify the information you’ve provided, arrange payment, and to activate your account so you can start saving. If you need to reach us right now, please call 1.800.880.6806, or e-mail info@chsa.ca

Enrollment

Name *

First

Last *

Last

Address *

Address Line 2

City *

Province *

Postal Code

Country *

Business Phone Number *

Email *

Ownership *

Contribution Frequency

Contribution Schedule

Name *

First

Last *

Last

Yearly Amount

Additional Employees will be added over the phone.

If you prefer download the complete set of forms and fax them to 1-800-880-6806.

{A} Business Enrollment Form As it Pertains to Your Province (Schedule A)

{B} Business Trust Agreement

{C}Employee Enrollment Form

Basic Rules

The minimum contribution per employee is $50 per month or $600 per year.

Define the total annual contribution for each employee and then determine the frequency of deposits. The contribution amount cannot be changed mid-year unless there is a "life event" such as marriage, birth, adoption, or death.

For unincorporated businesses, the maximum annual contribution limits are $1500 per adult, and $750 per dependent child covered by the plan. For plans that start mid-year, contribution limits will be pro-rated.

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