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Exhibit 10.1.1

AMENDMENT TO THE
EMPLOYMENT AGREEMENT WITH WILLIAM A. SANGER

        WHEREAS, EMSC, Inc. ("Purchaser") and William A. Sanger ("Executive")
entered into an Employment Agreement ("Agreement") on December 6, 2004, as
amended; and

        WHEREAS, the Purchaser and the Executive desire to amend the Agreement
to reflect compliance with the provisions of Section 409A of the Internal
Revenue Code of 1986, as amended.

        NOW, THEREFORE, the Agreement is hereby amended effective January 1,
2009 as follows:

        1.     The third sentence of Section 6(a)(i) is deleted and replaced
with the following:

Upon such termination, Purchaser may elect, in its sole and absolute discretion,
to pay the Executive his Base Salary in effect at the time of such termination
for a period of 24 months following such termination as consideration for
Executive's agreement set forth in paragraphs (b) and (c) of this Article 6, and
any such payment shall be made on the Purchaser's regularly scheduled payroll
dates during such period. Notwithstanding anything herein to the contrary, in
the event that Executive is determined to be a specified employee within the
meaning of Section 409A of the Internal Revenue Code of 1986, as amended
("Code") for purposes of any payment on termination of employment hereunder,
payment shall be made or begin, as applicable, on the first payroll date which
is more than six months following the date of separation from service, to the
extent required to avoid any adverse tax consequences under Section 409A of the
Code.

        2.     Section 6(a)(iii) is deleted and replaced with the following:

By Purchaser, in its absolute discretion and for any reason, without Cause. Upon
such termination, Purchaser shall (A) continue to pay the Executive his Base
Salary in effect at the time of such termination for a period of 24 months
following such termination, payable on the Purchaser's regularly scheduled
payroll dates during such period, (B) pay, or cause a Subsidiary to pay, the
Executive an equivalent lump sum cash amount in lieu of medical insurance,
dental insurance and term life insurance (but excluding the life insurance
referred to in the last sentence of paragraph (d) and Article 5) during the
applicable termination period, and such lump sum shall be payable upon such
termination, and (C) if the performance targets for the year are met, pay to
Executive a pro rata portion (equal to a fraction, of which the numerator is the
number of full months of Executive's employment in the year and the denominator
is 12), of the bonus payable to Executive pursuant to Section 4(b), at such time
as the Purchaser pays annual incentive bonuses for the year to executives of the
Purchaser. In the event of a termination under this Section, all time-governed
Sanger Options shall vest and be exercisable as and to the extent provided in
Article 4.

        3.     The following language is added to the end of Section 6(a):

Notwithstanding anything herein to the contrary, in the event that Executive is
determined to be a specified employee within the meaning of Section 409A of the
Code for purposes of any payment on termination of employment hereunder, payment
shall be made or begin, as applicable, on the first payroll date which is more
than six months following the date of separation from service, to the extent
required to avoid any adverse tax consequences under Section 409A of the Code.

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IN WITNESS WHEREOF, Purchaser and Executive have executed this Agreement, in
multiple counterparts, each of which shall be deemed an original, this 30th day
of December, 2008 and effective January 1, 2009.

PURCHASER
 
ATTEST:
By:
 
/s/ Todd G. Zimmerman

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By:
 

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Its:
 
Executive Vice President

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Its:
 

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EXECUTIVE
 
 
 
 
/s/ William A. Sanger

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Print:
 
William A. Sanger

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AMENDMENT TO THE EMPLOYMENT AGREEMENT WITH WILLIAM A. SANGER