The principle of the Health Spending Account (HSA) originated in the United States, where it was developed following the implementation of flexible benefit plans. The concept was imported to Canada in the late 1980s when Canadian Revenue Agency (CRA) adopted various Canadian rules with respect to benefit eligibility and tax treatment.

The popularity of Health Spending Accounts has increased during the past decade as employers have seen them as efficient tools to control the increasing cost of either the Fully Insured Traditional Benefit Plan or Private Health Plans while being able to offer their employees an attractive and affordable option that provides choices.