To amend title I of the Employee Retirement Income Security Act of 1974 to improve access and choice for entrepreneurs with small businesses with respect to medical care for their employees.

Small Business Health Fairness Act of 2009 - Amends the Employee Retirement Income Security Act of 1974 (ERISA) to provide for establishment and governance of association health plans (AHPs), which are group health plans whose sponsors are trade, industry, professional, chamber of commerce, or similar business associations, and which meet certain ERISA certification requirements.

Sets forth rules governing AHPs, including requirements relating to certification, sponsors and boards of trustees, participation and coverage, nondiscrimination, contribution rates, notice of voluntary termination, correction actions, and mandatory termination.

Establishes the Association Health Plan Fund to be used by the Secretary of Labor to make payments to an insurer to maintain coverage for a plan if there is a reasonable expectation that, without such payments, claims would not be satisfied by reason of termination of coverage.

Requires the Secretary to establish a Solvency Standards Working Group.

Allows a state to impose a contribution tax on an association health plan that commenced operations in such state after the enactment of this Act.

Preempts any state law that may preclude a health insurance issuer from: (1) offering health insurance coverage in connection with a certified AHP; or (2) offering health insurance coverage of the same policy type to other employers operating in the state that are eligible for coverage under such AHPs, whether or not such other employers are participating employers in such plan.