I think the nominal spindle dimensions are the same- Frank may correct me on this...
The Big Plus spindle has a ground face and the distance from the gage line to the spindle nose is held to tight tolerance.
On the holders, the flange is thicker on the Big Plus to take up the ~1/8" gap that you see in a standard CAT40. They look kind of like a cross between a BT and a standard CAT.
You can use standard CAT holders in Big Plus spindles, but the MTB's usually say don't mix-and-match, because there is a risk that a chip can get between the holder and the spindle nose with a standard CAT. Then you do a tool change and the chip can get squashed between the spindle nose and the Big Plus holder.
If you are tooling up from scratch, just buy dual contact everything. I use Techniks and Parlec holders and I like them, but I am planning on ordering a couple ER11 collet chucks from Maritool.
Mentioned above, you don't need the rigidity of the dual contact for most drilling and tapping operations- but if you have a high speed spindle, the dual contact will prevent the tool creeping up in the taper when the spindle is hot. A standard CAT40 holder can move a little as the spindle expands.