Fairness in Health Insurance Act of 2009

Fairness in Health Insurance Act of 2009 - Prohibits a health insurance issuer from offering health insurance coverage unless the issuer demonstrates that such coverage has a medical loss ratio of at least 90%.

Directs the Secretary: (1) to establish a uniform definition of "medical loss ratio" and methodology for calculating it, which shall take into account the circumstances of different plans and activities related to health services, such as chronic disease management and quality assurance; and (2) by December 31, 2010, to develop, publish, and implement the standardized data elements and definitions to be used by health insurance issuers in the reporting of data necessary to calculate such ratio.

Requires each issuer: (1) beginning in plan year 2011, to provide the Secretary with data to enable the Secretary to determine whether the issuer is in compliance with this Act; and (2) to provide payment rebates to enrollees for any plan year in which the coverage has a medical loss ratio below 90%.