Due to its near-universal adoption, speed, and cost-effectiveness, email remains one of the most common communication channels in healthcare. Consequently, it’s one of the most frequent targets for cyber attacks, as malicious actors are acutely aware of the vast amounts of sensitive data contained in messages – and standard email communication’s inherent vulnerabilities.

In light of this, healthcare organizations must remain aware of the evolving email threat landscape, and implement effective strategies to protect the electronic protected health information (ePHI) included in email messages. Failing to properly secure email communications jeopardizes patient data privacy, which can disrupt operations, result in costly HIPAA compliance violations, and, most importantly, compromise the quality of their patients’ healthcare provision.

With all this in mind, this post details the biggest email threats faced by healthcare organizations today, with the greatest potential to cause your business or practice harm by compromising patient and company data. You can also get our 2025 report on the latest email threats, which includes strategies on how to overcome them.

Ransomware Attacks

Ransomware is a type of malware that encrypts, corrupts, or deletes a healthcare organization’s data or critical systems, and enables the cybercriminals that deployed it to demand a payment (i.e., a ransom) for their restoration. Healthcare personnel can unwittingly download ransomware onto their devices by opening a malicious email attachment or clicking on a link contained in an email.

In recent years, ransomware has emerged as the email security threat with the most significant financial impact. In 2024, for instance, there were over 180 confirmed ransomware attacks with an average paid ransom of nearly $1 million. 

Email Client Misconfiguration

While a healthcare organization may implement email security controls, many fail to know the security gaps of their current email service provider (ESP) or understand the value of a HIPAA compliant email platform, leaving data vulnerable to email threats, such as unauthorized access and ePHI exposure, and also, subsequently, a greater risk of compliance violations and reputation damage.

Common types of email misconfiguration include:

• Lack of enforced TLS encryption: resulting in emails being transmitted in plaintext, rendering the patient data they contain readable by cybercriminals in the event of interception during transit.
• Improper SPF/DKIM/DMARC setup: failure to configure or align these email authentication protocols correctly gives malicious actors greater latitude to successfully spoof trusted domains.
• Disabled or lax user authentication: a lack of authentication measures, such as multi-factor authentication (MFA), increases the risk of unauthorized access and ePHI exposure.
• Misconfigured secure email gateways: incorrect rules or filtering policies can allow phishing emails through or block legitimate messages.
• Outdated or unsupported email client software: simply neglecting to download and apply the latest updates or patches from the email client’s vendor can leave vulnerabilities, which are well-known to cybercriminals, exposed to attack.

Social Engineering Attacks

A social engineering attack involves a malicious actor deceiving or convincing healthcare employees into granting unauthorized access or exposing patient data. Relying on psychological manipulation, social engineering attacks exploit a person’s trust, urgency, fear, or curiosity, and encompass an assortment of threats, including phishing and business email compromise (BEC) attacks, which are covered in greater depth below.

Phishing

As mentioned above, phishing is a type of social engineering attack, but they are so widespread that it warrants its own mention. Phishing sees malicious actors impersonating legitimate companies, or their employees, to trick victims into revealing sensitive patient data. 

Subsequently, healthcare organizations can be subjected to several different types of phishing attacks, which include:

• General phishing: otherwise known as bulk phishing or simply ‘phishing’, these are broad, generic attacks where emails are sent to large numbers of recipients, impersonating trusted entities to steal credentials or deliver malware. 
• Spear phishing: more targeted attacks that involve personalized phishing emails crafted for a specific healthcare organization or individual. These require more research on the part of malicious actors and typically use relevant insider details gleaned from their reconnaissance for additional credibility.
• Whaling: a form of spear phishing that specifically targets healthcare executives or other high-level employees. 
• Clone phishing:  when a cybercriminal duplicates a legitimate email that was previously received by the target, replacing links or attachments with malicious ones.
• Credential phishing: also known as ‘pharming’, this involves emails that link to fake login pages designed to capture healthcare employees’ usernames and passwords under the guise of frequently used legitimate services.

Domain Impersonation and Spoofing

This category of threat revolves around making malicious messages appear legitimate, which can allow them to bypass basic email security checks. As alluded to above, these attacks exploit weaknesses in email client misconfigurations to trick the recipient, typically to expose and exfiltrate patient data, steal employee credentials, or distribute malware.

Domain spoofing email threats involve altering the “From” address in an email header to make it appear to be from a legitimate domain. If a healthcare organization fails to properly configure authentication protocols like SPF, DKIM, and DMARC, there’s a greater risk of their email servers failing to flag malicious messages and allowing them to land in users’ inboxes.

Domain impersonation, on the other hand, requires cybercriminals to register a domain that closely resembles a legitimate one. This may involve typosquatting, e.g., using “paypa1.com” instead of “paypal.com”. Alternatively, a hacker may utilize a homograph attack, which substitutes visually similar characters, e.g., from different character sets, such as Cyrillic. Malicious actors will then send emails from these fraudulent domains, which often have the ability to bypass basic email filters because they aren’t exact matches for blacklisted domains. Worse still, such emails can appear authentic to users, particularly if the attacker puts in the effort to accurately mimic the branding, formatting, and tone used by the legitimate entity they’re attempting to impersonate. 

Insider Email Threats

In addition to external parties, employees within a healthcare organization can pose email threats to the security of its PHI. On one hand, insider threats can be intentional, involving disgruntled employees or third-party personnel abusing their access privileges to steal or corrupt patient data. Alternatively, they could be the result of mere human error or negligence, stemming from ignorance, or even fatigue.

What’s more, insider threats have been exacerbated by the rise of remote and flexible conditions since the onset of the COVID-19 pandemic, which has created more complex IT infrastructures that are more difficult to manage and control.  

Business Email Compromise (BEC) Attacks

A BEC attack is a highly targeted type of social engineering attack in which cybercriminals gain access to, or copy, a legitimate email account to impersonate a known and trusted individual within an organization. BEC attacks typically require extensive research on the targeted healthcare company and rely less on malicious links or attachments, unlike phishing, which can make them difficult to detect.

Due to the high volume of emails transmitted within the healthcare industry, and the sensitive nature of PHI often included in communications to patients and between organizations, the healthcare industry is a consistent target of BEC attacks.

BEC attacks come in several forms, such as:

• Account compromise: hijacking a real employee’s account and sending fraudulent messages.
• Executive fraud: impersonating high-ranking personnel to request urgent financial transactions or access to sensitive data.
• Invoice fraud: pretending to be a vendor asking for the payment of a fraudulent invoice into an account under their control.

Supply Chain Risk

Healthcare organizations increasingly rely on third-party vendors, including cloud service providers, software vendors, and billing or payment providers to serve their patients and customers. They constantly communicate with their supply chain partners via email, with some messages containing sensitive patient data; moreover, some of these organizations will have various levels of access to the PHI under their care.

Consequently, undetected vulnerabilities or lax security practices within your supply chain network could serve as entry points for email threats and malicious action. For instance, cybercriminals can compromise the email servers of a healthcare company’s third-party vendor or partner, and then send fraudulent emails from their domains to deploy malware or extract patient data.

Another, somewhat harrowing, way to understand supply chain risk is that while your organization may have a robust email security posture, in reality, it’s only as strong as that of your weakest third-party vendor’s security controls.

Download LuxSci’s Email Cyber Threat Readiness Report

To gain further insight into the biggest email threats to healthcare companies in 2025, including increasingly prevalent AI threats, download your copy of LuxSci’s Email Cyber Threat Readiness Report. 

You’ll also learn about the upcoming changes to the HIPAA Security Rule and how it’s set to impact your organization going forward, and the most effective strategies for strengthening your email security posture.

Grab your copy of the report here and begin the journey to strengthening your company’s email threat readiness today.

Email is still one of the most pervasive and trusted digital communication channels in use today — and it’s not going anywhere. For health insurance providers and health plan system administrators, email presents a major opportunity: the ability to communicate reliably, more personally, and more effectively with members and customers.

Despite this, some health insurers and plan providers are wary of utilizing email to its full potential for fear of running afoul of HIPAA regulations. Or worse, they think they’re HIPAA compliant when they may not be, or they don’t think they need to be compliant when it comes to certain communications.

When email is encrypted properly, it becomes a direct, compliant channel for everything from new plan enrollments and policy changes to Explanation of Benefits (EOBs) and reimbursements. With the right encryption methods and best practices in place, you can deliver the kind of personalized, efficient experiences that today’s members and customers expect, while meeting the highest standards for privacy and security.

With this in mind, let’s explore the most impactful HIPAA compliant email use cases for health plan administrators and health insurance providers – and how enabling secure, fully encrypted email with LuxSci can improve member engagement, drive more efficient processes, speed payment, and deliver better results and outcomes.

Email: A Highly Trusted Healthcare Communication Channel

Everyone uses email. It’s a daily habit for billions of people – including your members and customers. Email is also a top channel for baby boomers, and it will continue to be for years to come.

Simply put, people are familiar and comfortable with how email works, they trust it, and email doesn’t require the installation and use of another app or logging into a separate portal. For health plans and insurers, this means you can meet members and customers directly where they already are, through a highly used method of communication.

A Private and Preferred Option for Key Healthcare Conversations

When designed with security in mind, email is perfectly suited for delivering sensitive healthcare information, i.e., protected health information (PHI) and conversations about an individual’s health condition, related treatment, and insurance coverage. Just as importantly, it’s can be less invasive than SMS, and more effective – not to mention cheaper – than printed mail, making it an ideal choice for critical, high-touch communications, such as member benefits, policy updates, and billing.

HIPAA Compliance: Securing Better Digital Engagement

HIPAA compliance often gets framed as a limitation; in reality, however, it provides the framework for secure, scalable communications in healthcare.

With the right HIPAA compliant email solution, health plan administrators and health insurers can:

• Deliver personalized content directly to members and customers – securely
• Automate secure communications and related workflows
• Avoid the additional friction of portals – and capture non-portal users
• Ensure privacy and legal protection for sensitive data

Rather than avoiding email for sensitive communications, more and more organizations are now embracing secure email to improve engagement, click-throughs and conversions. This translates to more timely plan enrollments, more policy renewals and faster payments.

Compliance Enables Engagement, Not the Other Way Around

When you build compliance into your communications strategy, you unlock more ways to engage with members effectively. Confident in the safeguards you have in place to protect sensitive member and customer data, you can personalize your email communications, segmenting members according to their healthcare needs, their status within your organization, or their individual situation (recently joined, long-time member, disengaged, etc).

Consequently, HIPAA compliance doesn’t have to slow you down, as it’s persistently perceived to, it actually enables you to harness the possibilities of personalization to drive better engagement and better results.

HIPAA Compliant Email Use Cases for Health Plan Administrators and Insurers 

Let’s turn our attention to five highly applicable use cases for HIPAA compliant email for health plans and insuers, and how they can benefit your company, as well as your members or customers. 

Use Case #1: Sending Explanation of Benefits (EOBs)

Why It Matters: Reliable delivery, faster payments

In most cases, EOBs are still sent via physical mail, which is slow, costly, often misunderstood, and may never reach the intended recipient for myriad reasons. Conversely, with HIPAA compliant email, you can deliver digital EOBs directly to members in a format they can understand and trust is secure – at a much lower cost.

Benefits

• Increased deliverability
• Reduce printing and mailing costs
• Reduced carbon footprint
• The ability to track message activity, i.e., if delivered, opened, etc.

Try the LuxSci EOB ROI calculator here, and see how you can save millions of dollars per month with HIPAA compliant email EOBs.

Use Case #2: New Plan Enrollments

Why It Matters: Secure enrollments, faster and on time

Enrollment is a crucial moment on the member journey. With secure email, you can onboard new members more quickly by reaching them directly via their inbox, providing them with their enrollment instructions, required logins, delivering their plan details, and supplying coverage summaries. All of which can be achieved without them having to wait for the mail or chase portal logins.

Benefits

• Real-time delivery of enrollment and onboarding materials
• Immediate coverage confirmation
• Easier to troubleshoot potential issues
• Enhanced support with secure reply options

Use Case #3: Policy Change and Renewal Notifications

Why It Matters: Transparency and speed build trust

Policy updates, such as changes to deductibles, coverage, or provider networks, must be communicated clearly and as soon as possible. HIPAA compliant email makes it simple to notify members and deliver legally required communications reliably and securely.

Benefits

• Keep members better informed and more empowered to make healthcare decisions
• Meet regulatory deadlines
• Align with compliance requirements
• Reduce call center volume from confused policyholders 

Use Case #4: Payments, Reimbursements and Financial Communications

Why It Matters: Payment and coverage clarity drives satisfaction, business continuity

From payment confirmations to out-of-pocket estimates, secure email gives members clear, timely financial updates, allowing them to plan accordingly. This makes them feel their healthcare providers are being open with them and transparent in communications for payments.

In contrast, confusion about benefits, coverage, and costs diminishes trust, which strains communication and makes effective engagement difficult. Financial clarity also accelerates your organization’s internal processes, enhancing efficiency and your ability to provide the best possible service to members. 

Benefits

• Increased member trust and satisfaction
• Speed up reimbursement cycles
• Reduce payment confusion
• Enable secure document submission (e.g., receipts, claims)

Use Case #5: Education and Preventive Health Campaigns

Why It Matters: Proactive education supports better health outcomes

Use HIPAA compliant email to send targeted content, including preventive screening reminders, wellness resources, and seasonal health tips, while effectively securing PHI. Members benefit by taking a more active role in their healthcare journeys and committing to better health, which reduces healthcare costs and improves outcomes.

Benefits

• Educated members are more involved in their healthcare journey
• Personalized health education based on member history
• Secure mass communication that meets HIPAA standards
• Improved health outcomes and engagement

LuxSci for Health Plan Administrators and Insurers

HIPAA compliance isn’t the end of the conversation – it’s really the beginning of smarter and more secure engagement that has a real impact on business results, as well as member and customer satisfaction.

LuxSci is a trusted provider of secure email solutions tailored for healthcare organizations. With over 20 years of experience supporting HIPAA compliance and HITRUST certification, LuxSci enables compliance, marketing, operations, and IT teams to send high-volume, secure, personalized email – all without compromising privacy or performance.

Key Features

• Automated encryption (TLS, PGP, S/MIME), which sets encryption according to message sensitivity and the recipient’s email security posture
• Secure SMTP and API-based sending
• Real-time tracking and delivery reporting
• Automated workflows
• Configurable access controls and user management
• Full BAA coverage and dedicated infrastructure

Whether you’re sending thousands of onboarding emails or automating payment updates, LuxSci helps you do it securely, seamlessly, and at scale.

Ready to unlock the full potential of HIPAA compliant email?

Contact LuxSci today to discover more about how our solutions can enable more effective, more personalized healthcare communication. 

Health Plan Administrator and Insurance Provider Secure Email Use Cases FAQs

How Does HIPAA Enable Better Email Communications for Health Plans?

HIPAA provides the framework for secure, HIPAA compliant communication of electronic protected health information (ePHI), allowing health plans and insurers to safely send personalized, high-impact emails to members.

Can We Use Email for Mass Communications Involving PHI?

Indeed, you can. LuxSci provides the infrastructure to send thousands, or even millions, of encrypted email communications containing PHI –  securely, compliantly, and with fully encrypted content.

Is Secure Email More Effective Than Traditional Member Portals?

In many cases, yes: Secure email bypasses portal fatigue, created by the friction of your members having to log into a separate platform to receive key communications. Conversely, secure email platforms, like LuxSci, deliver  messages directly to the inbox where members are more likely to read and respond.

What Makes Luxsci Different from Other Secure Email Providers?

LuxSci’s solutions have been built from the ground up with the stringent compliance and secuirty needs of healthcare organizations in mind. This translated into providing HIPAA-compliant email communication without sacrificing usability, supporting high-volume sending, flexible encryption options, and seamless integration into your existing systems.