Document:

EXHIBIT 4.1
                                                                     -----------

                            CAS MEDICAL SYSTEMS, INC.

                   1994 EMPLOYEES' INCENTIVE STOCK OPTION PLAN

         1.  Purpose. The purpose of this 1994 Employees' Incentive Stock Option
Plan (hereinafter referred to as the "Plan"), which is intended to qualify as an
incentive stock option plan within the meaning of Section 422 of the Internal
Revenue Code of 1986, as amended (the "Code"), is to encourage and enable the
employees of CAS Medical Systems, Inc., and its subsidiaries, if any
(hereinafter collectively called the "Company"), to acquire a proprietary
interest in the Company through the ownership of shares of Common Stock, in
order to assure a closer identification of their interests with those of the
Company by providing them with a more direct stake in its welfare, thereby
stimulating their efforts on the Company's behalf and strengthening their desire
to remain with the Company. This is accomplished by the granting of options to
qualified employees of the Company.

         2.  Amount of Stock Subject to the Plan. The total number of shares of
the Company's Common Stock which may be sold pursuant to the Plan shall not
exceed 1,250,000 shares plus an indeterminate number of shares required to be
issued pursuant to Paragraph 10 of the Plan. Shares sold under the Plan may be
reacquired by the Company at any time, as the Board of Directors of the Company,
from time to time, may determine. In the event that any options granted under
the Plan shall not have been exercised in full, the shares not purchased
hereunder shall be available again for purposes of the Plan.

         3.  Administration of the Plan. The Board of Directors shall administer
the Plan, including, without limitation:

         (a) Determination of participants, allotment of shares and prices of
shares;

         (b) Construing, amending or rescinding terms of the Plan; and

         (c) The terms and conditions of each option agreement for the purchase
of stock under the Plan, subject to the provisions of the Plan.

         The Company's contribution to the Plan will consist of making its
shares of Common Stock available for purchase by employees and bearing all costs
of administering the Plan.

         4.  Eligibility. All persons employed by the Company, now, or in the
future, including officers of the Company, shall be eligible to participate
under the Plan, but shall have no right to participate in the Plan except as
specifically determined in each instance by the Board of Directors.

<PAGE>

         5. Time of Granting Options. Neither anything contained in the Plan nor
in any resolution adopted or to be adopted by the Board of Directors or by the
stockholders of the Company shall constitute the granting of any options under
the Plan. The granting of an option to purchase stock shall take place only when
a Grant of Option shall have been duly executed and tendered to the employee by
or on behalf of the Company.

         6. Terms of Options. The terms of each option granted under the Plan
shall be determined by the Board of Directors consistent with the provisions of
the Plan, and shall include the following:

         (a) An option granted under the Plan must be granted within ten (10)
years from the date the Plan is adopted by the Board of Directors, or the date
the Plan is approved by the stockholders of the Company, whichever is earlier.

         (b) The purchase price of the shares subject to each option shall not
be less than the fair market value of the Company's Common Stock at the time
such option is granted except, however, that if the optionee owns more than 10%
of the outstanding Common Stock of the Company at the time the option is
granted, including stock attributable to the optionee under applicable
provisions of the Code but not including stock obtainable under the option, the
purchase price of the shares to the optionee shall not be less than 110% of the
fair market value of the Common Stock at the time such option is granted. Such
fair market value shall be determined by the Board and good faith shall be
exercised in such determination.

         (c) An option granted under the Plan shall become exercisable in two
equal annual installments, commencing one year from the date of the grant of the
option. Each option granted under the Plan shall be its terms expire and shall
not be exercisable after the expiration of ten (10) years from the date of the
grant except, however, that if the optionee owns more than 10% of the
outstanding Common Stock of the Company at the time the option is granted,
including stock attributable to the optionee under applicable provisions of the
Code but not including stock obtainable under the option, any option granted to
such optionee shall not be exercisable after the expiration of five (5) years
from the date of its grant. Every option granted under the Plan shall be subject
to early termination as expressly provided in Paragraph 11 hereof.

         (d) In the event that employment of an optionee by the Company or any
subsidiary is terminated for any reason other than death, an option granted
hereunder shall be exercisable by the optionee at any time prior to the
expiration date of the option or within three months after the date of such
termination, whichever is earlier, but only to the extent the optionee had the
right to exercise such option at the date of such termination. In the event of
the death of an optionee while in the employ of the Company (or within three
months after termination of employment by reasons of retirement with the consent
of the Company), his option shall be exercisable by the person or persons to
whom such optionee's rights pass by will or by the laws of descent and
distribution at any time prior to the expiration date of thew option or within
three months after the date of such death, whichever is earlier, but only to the
extent the optionee had the right to exercise such option on the date of his
death.
<PAGE>

         (e) The aggregate fair market value (determined at the time the option
is granted) of the shares with respect to which the option is exercisable for
the first time by the Optionee during any calendar year (under all plans
relating to incentive stock options, as defined in the Code, maintained by the
Company and a parent and subsidiary corporation of the Company and a predecessor
corporation of any such corporation shall not exceed one hundred thousand
dollars ($100,000).

         (f) An option granted under the Plan shall be exercised by the delivery
by the holder thereof to the Company at its principal office (attention of the
Secretary) of written notice of the number of shares with respect to which the
option is being exercised, accompanied by payment in full by check payable to
the order of the Company, of the purchase price of such shares.

         7.  Status as Stockholder. No employee shall, by reason of the Plan or
any rights granted pursuant thereto, have any rights of a stockholder of the
Company until shares of stock shall have been delivered to him by the Company.

         8.  Non-Transferability. An option granted under the Plan shall not be
transferable other than by will or the laws of descent and distribution, and any
option granted under the Plan may be exercised during the lifetime of the holder
thereof only by him. No right granted under the Plan to an employee may be
pledged, hypothecated, assigned, or otherwise encumbered by him.

         9.  Use of Funds. Funds paid in purchase of the stock are to be added
to the general funds of the Company and may be used by the Company for any
lawful purpose.

         10. Dilution or Other Adjustments. In the event that there is any
change in the stock subject to the Plan through merger, consolidation or
reorganization, or in the event of any change in the capital structure, the
Board of Directors of the Company shall make such adjustments as it, in its sole
discretion, deems equitable to prevent dilution or enlargement of the employee's
rights hereunder. In the event that the Company should declare a stock dividend
on its shares of Common Stock, the number of shares which an employee has
elected to purchase but which have not been delivered at the record date of such
stock dividend shall be changed proportionately to the extent of the number of
whole shares that would have been issuable on such stock; no provision will be
made for, or in lieu of, fractional shares.

         11. Termination and Amendment of the Plan. The Plan is scheduled to
terminate December 31, 2003; however, the Board of Directors of the Company
shall have the right, at any time, to amend, suspend or terminate the Plan in
any respect which it may deem to be in the best interests of the Company,
provided, however, no amendments shall be made in the Plan without the approval
of the stockholders of the Company which:

         (a) Increase the total number of shares for which options may be
granted under this Plan for all employees or for any one of them except as
provided herein.
<PAGE>

         (b) Change the minimum purchase price for the optioned shares, except
as provided herein.

         (c) Affect outstanding options or any unexercised rights thereunder,
except as provided herein.

         (d) Extend the option period provided in Section 6 or make an option
exercisable earlier than as specified in Section 6.

         (e) Extend the termination date of the Plan.

         12. Plan Not an Employment Contract. The Plan does not and shall not be
deemed to constitute a contract of employment with any employee. Terms of
employment and the right of the Company to terminate the employment of any
employee, with or without cause, shall depend entirely upon the terms of
employment otherwise existing between any employee and the Company without
regard to the Plan.

         13. Approval of Issuance. The Company shall not be obligated to issue
and deliver any shares of Common Stock until there has been qualification under
or compliance with such state or federal laws, rules or regulations as the
company may deem applicable. If requested by the Company, any employee acquiring
shares of Common Stock hereunder shall deliver a representation to the Company
to the effect that such shares are being acquired for investment and not with a
view to the resale or distribution thereof.

         14. Governing Law. The Plan shall be governed by and all questions
arising hereunder shall be determined in accordance with the laws of the State
of Delaware.

         15. Other Terms and Conditions. Any option granted hereunder shall
contain such other and additional terms, not inconsistent with the terms of this
Plan, which are deemed necessary or desirable by the Board, which such terms,
together with the terms of this Plan, shall constitute such option as an
"Incentive Stock Option" within the meaning of Section 422 of the 1986 Internal
Revenue Code and lawful regulations thereunder.

         16. Effective Date, Term and Approval. Subject to the approval of the
stockholders of the Company at the Annual Meeting in 1994, the Plan shall take
effect on April 1, 1994. This Plan will terminate on December 31, 2003, and no
options may be granted under the Plan after that date unless an earlier
termination date after which no options may be granted under the Plan is fixed
by action of the Board of Directors, but any option granted prior thereto may be
exercised in accordance with its terms. The Plan and all options granted
pursuant to it are subject to all laws, approvals, requirements and regulations
of any governmental authority which may be applicable thereto and,
notwithstanding any provisions of the Plan or option agreement, the holder of an
option shall not be entitled to exercise his option nor shall the Company be
obligated to issue any shares to the holder if such exercise or issuance shall
constitute a violation by the holder or the Company of any provisions of any
such approval requirements, law or regulation.

As amended by the Board of Directors on October 26, 1999MCI WORLDCOM NETWORK SERVICES, INC.

                                 AMENDMENT NO. 2

     This  Amendment  No.  2  is  made  this 14th day of September, 2000, by and
between  GTC  Telecom,  Inc.  (successor-in-interest  to  Genx,  L.L.C.,  d/b/a
Preferred  Discount  Plan)  ("CUSTOMER") and MCI WORLDCOM Network Services, Inc.
(successor-in-interest  to WorldCom Network Services, Inc.) ("MCI WORLDCOM"), to
those  certain  Program  Enrollment  Terms  (the  "PET"),  to  that  certain
Telecommunications  Services  Agreement  more  particularly  described  as  TSA#
GNX-991201  (the  "TSA"),  made  by  and between Customer and MCI WorldCom dated
August  20, 1999, including that certain Amendment No. 1 dated February 9, 2000.
In  the  event  of any conflict between the terms of the TSA, the PET, Amendment
No.  1  or  any applicable Attachment and the terms of this Amendment No. 2, the
terms  of  this  Amendment  No.  2  shall  control.  The TSA along with the PET,
Amendment  No.  1,  all applicable Attachment(s), and this Amendment No. 2 shall
collectively  be  referred to as the "AGREEMENT".  Capitalized terms not defined
herein  shall  have  the  meaning ascribed to them in other documents referenced
herein.

     In  consideration  of  good  and  valuable  consideration,  the receipt and
sufficiency  of  which  are  hereby  acknowledged, the parties agree as follows:

1.     SERVICE  TERM.  As  of  August  1,  2000, the parties agree to substitute
Section  1  of  the  PET  to  read  in  its  entirety  as  follows:

1.     SERVICE  TERM:  This  Agreement  shall  commence  as  of December 1, 1999
[NOTE: THIS DATE SHOULD BE THE ORIGINAL EFFECTIVE DATE.] (the "EFFECTIVE DATE"),
and  shall  continue  through and include November 1, 2003 (the "SERVICE TERM").
Upon  expiration  of  the  Service  Term, the Switched Services in question will
continue to be provided pursuant to the same terms and conditions as are then in
effect  (including  without  limitation,  the  applicable  rates,  discounts and
commitments,  if  any),  subject to termination by either party upon thirty (30)
days  prior  written  notice  to  the  other  party.

2.     CUSTOMER'S  MINIMUM  REVENUE  COMMITMENTS.  As  of  August  1,  2000, the
parties  agree  to  substitute  Section  5 of the PET to read in its entirety as
follows:

5.     CUSTOMER'S  MINIMUM  REVENUE  COMMITMENTS:

(A)     Commencing  with  Customer's August 2000 billing period (i.e., September
2000 invoice) and continuing through January 2001 billing period (i.e., February
2001 invoice) (the "FIRST COMMITMENT PERIOD"), Customer agrees to maintain, on a
take-or-pay  basis, cumulative Monthly Revenue of at least $400,000 ("CUSTOMER'S
FIRST  MINIMUM  REVENUE  COMMITMENT").  Commencing with Customer's February 2001
billing  period (i.e., March 2001 invoice) and continuing through the end of the
Service  Term  (including  any  extensions  thereto)  (the  "SECOND  COMMITMENT
PERIOD"),  Customer  agrees  to  maintain,  on  a  take-or-pay basis, cumulative
Monthly  Revenue  of  at  least  $520,000  ("CUSTOMER'S  SECOND  MINIMUM REVENUE
COMMITMENT").  Further,  commencing  with  Customer's August 2000 billing period
(i.e.,  September  2000  invoice)  and continuing through the end of the Service
Term  (including  any  extensions  thereto)  (the  "TOTAL  COMMITMENT  PERIOD"),
Customer  agrees to maintain, on a take-or-pay basis, cumulative Monthly Revenue
of  at  least  $18,000,000  ("CUSTOMER'S  TOTAL  MINIMUM  REVENUE  COMMITMENT").

(B)     Notwithstanding anything to the contrary contained in this Agreement, as
soon  as Customer's cumulative Monthly Revenue from MCI WorldCom under the terms
of  this  Agreement  and  commencing  with Customer's August 2000 billing period
(i.e.,  September  2000  invoice) are equal to at least Customer's Total Minimum
Revenue  Commitment  (i.e., $18,000,000 in the aggregate), Customer may elect to
terminate  Customer's  Minimum  Revenue  Commitment described in Subsection 5(A)
above  by  providing  MCI  WorldCom written notice ("CUSTOMER NOTICE").  In such
event,  commencing with the first day of the first full month following at least
thirty  (30)  days  after  MCI WorldCom receives the Customer Notice, Customer's
Minimum  Revenue  Commitment  shall  terminate and will no longer be in force or
effect.

3.     DEFICIENCY CHARGE.  As of August 1, 2000, the parties agree to substitute
Section  6  of  the  PET  to  read  in  its  entirety  as  follows:

6.     DEFICIENCY  CHARGE.  In  the  event Customer does not maintain Customer's
First  Minimum  Revenue  Commitment  or  Customer's  Second  Minimum  Revenue
Commitment,  whichever  is applicable, during the First Commitment Period or the
Second  Commitment  Period,  whichever  is applicable, then for those Commitment
Periods  only,  Customer  will  pay MCI WorldCom, in addition to charges due for
Switched  Services  provided  to  Customer,  the  difference  between Customer's
applicable  Minimum  Revenue Commitment and Customer's actual cumulative Monthly
Revenue  for  the  applicable  Commitment Period (the "DEFICIENCY CHARGE").  The
Deficiency  Charge  will  be  due  at  the same time payment is due for Switched
Services  provided  to  Customer  for the billing period in which the Deficiency
Charge  arises,  or  immediately  in an amount equal to Customer's First Minimum
Revenue  Commitment  and Customer's Second Minimum Revenue Commitment, whichever
is  applicable,  for  the unexpired portion of the Service Term, if MCI WorldCom
terminates  this Agreement based on Customer's default or if Customer terminates
this  Agreement  pursuant  to  Section  2(A)  of the TSA.  Further, in the event
Customer  does  not  maintain Customer's Total Minimum Revenue Commitment by the
end  of  the  Service  Term,  Customer agrees to pay MCI WorldCom the difference
between  Customer's  Total  Minimum  Revenue  Commitment  and  Customer's actual
cumulative  Monthly  Revenue (which shall include any Monthly Deficiency Charges
paid  by  Customer)  during  the  Total Commitment Period (the "TOTAL DEFICIENCY
CHARGE").  The Total Deficiency Charge, if any, will be due within ten (10) days
following  the  end  of  the  Service Term, or immediately in an amount equal to
Customer's  Total  Minimum  Revenue  Commitment  less  Customer's actual Monthly
Revenue  through  the  effective  date of termination if MCI WorldCom terminates
this  Agreement  based  on Customer's default.  It is agreed that MCI WorldCom's
damages in the event Customer fails to maintain Customer's First Minimum Revenue
Commitment,  Customer's  Second  Minimum Revenue Commitment and Customer's Total
Minimum  Revenue  Commitment shall be difficult or impossible to ascertain.  The
provision  for a Deficiency Charge and a Total Deficiency Charge in this Section
6  is intended, therefore, to establish liquidated damages in the event Customer
fails to maintain Customer's First Minimum Revenue Commitment, Customer's Second
Minimum  Revenue  Commitment and Customer's Total Minimum Revenue Commitment and
is  not  intended  as  a  penalty.

4.     SPECIAL RATES.  Notwithstanding anything to the contrary contained in the
applicable  Attachment(s)  attached  to  the  TSA,  commencing  within  ten (10)
business  days following MCI WorldCom's execution of this Amendment No. 2, which
date  will  be determined by MCI WorldCom in its sole discretion, and continuing
through  the  end of the Service Term, with respect to TRANSCEND  2000 Services,
Customer will receive the special rates (the "SPECIAL RATES") for the Service(s)
shown  below.  All  other  rates  and  discounts  will  be  as  set forth in the
applicable  Attachment(s).

     (i)     TRANSCEND  2000  Services  -  Customer's  Domestic Transport Charge
will  be  $______  per  minute.

     (ii)     TRANSCEND  2000  Services  -  Customer's  International  Transport
Charges  for  calls  to Mexico will be the respective rates per minute set forth
below:  [Note:  The  Special  Rates  set forth below are for land-line transport
only;  access  charges  and  domestic  transport  charges  not  included.]

                              MEXICO      RATE
                              PEAK     $
                              OFF PEAK $

(B)     Notwithstanding  anything  to  the  contrary  contained  in the TSA, MCI
WorldCom  reserves the right to modify the Special International Rates described
in  Subsection  (A)  above  (which  charge  modifications  shall  not  exceed
then-current  generally available MCI WorldCom charges for comparable services),
upon  not  less  than  fifteen  (15)  calendar  days'  prior  notice to Customer
(facsimile being acceptable), which notice will state the effective date for the
charge  modification.

5.     OTHER  TERMS  AND CONDITIONS.  Except as specifically amended or modified
herein,  the terms and conditions of the Agreement will remain in full force and
effect  throughout  the  Service  Term  and  any  extensions  thereof.

     IN  WITNESS  WHEREOF, the parties have entered into this Amendment No. 2 on
the  date  first  written  above.

MCI  WORLDCOM  NETWORK
SERVICES,  INC.                       GTC  TELECOM,  INC.

    /s/ Dennis P. Delaney                /s/ S. Paul Sandhu
By:----------------------------      By:----------------------------
   (Signature)                                (Signature)
    Dennis P. Delaney                    S. Paul Sandhu
-------------------------------      -------------------------------
   (Print  Name)                             (Print  Name)

      Director                           President & CEO
-------------------------------      -------------------------------
        (Title)                                   (Title)

       9-15-00                                 9-14-00
-------------------------------      -------------------------------
        (Date)                                   (Date)

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